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Alabama Medicaid

Monday, December 4, 2023
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Provider Electronic Solution (PES) Software

PLEASE REVIEW PRIOR TO SELECTING AN OPTION FOR SOFTWARE DOWNLOAD Provider Electronic Solutions Software version 3.13 is now available.
  • Software version 3.14 includes changing the Service Authorization descriptions and updating the Help Section.
  • Software version 3.13 includes the addition of Referral Number on the Professional claim form and adding a submission clarification code to the Pharmacy claim form.
  • Software version 3.12 includes the addition of Quantity Prescribed on the Pharmacy claim form and updates to the Gainwell logo.
  • Software version 3.11 includes the addition of the PWK Segment (Electronic Attachments) to all 837 claim forms and the incentive amount field to the Pharmacy claim form.
  • Software version 3.10 includes updates to NCDCP Pharmacy form to include conflict code ingredient duplication and update 837 Professional claim form to include new maternity date fields.
  • Software version 3.09 includes changing "RCO" references to "MCO" on eligibility response file and removing message regarding RCO from claim status response. Change field label on 837 claim forms crossover tab and eligibility response to display Medicare ID field label instead of HIC Number.
Please refer to Appendix C Change Log in the software User Manual for a full list of the changes included in the new Provider Electronic Solution software version.

  • Software version 3.02 and all subsequent software versions will include changes for ICD-10.
  • ICD-10 codes should not be submitted until the CMS mandated date of October 1, 2015.
  • The ICD version on new Claims and Prior Authorizations will default to blank.
  • The Procedure/HCPCS and Diagnosis list are split based on ICD version.
  • Users may begin building ICD-10 lists now.
Users must perform an upgrade through each software version to successfully upgrade an older version of a database.

LTC Admission Notification