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Referral Information for Providers

A referral form must be submitted for all referrals in order to be processed. 

Please fax the referral to (256) 382-2715 or email to


Please note that the email address is for provider use only. Recipients should contact us directly using our Contact Us Form (Click HERE) or by calling (256) 382-2590 to prevent delays.

Specialist Referrals

North Alabama Community Care’s goal is for Primary Care Providers (PCPs) to make referrals for Specialist services and for Medicaid Recipients to be under the care of a PCP (Ref: Chapter 40 of Provider Billing Manual).  However, North Alabama Community Care will provide referrals for Specialist services for Medicaid Recipients who are not yet attributed to a PCP.  Referrals are for billing purposes only and intended to assist Medicaid Recipients and Providers in the interim while Recipients are being linked with PCPs.

Alabama Medicaid Agency's presentation on the "Role of the Specialist in the ACHN"

Submitting Specialist Referrals

When submitting a Specialist Referral, please use the follow instructions:

  • Verify the Recipient’s Medicaid eligibility

  • Verify the Recipient’s ACHN assignment

    • North Alabama Community Care is listed as  “ACHNB”

  • Verify the Primary Care Provider attribution

    • Attributed Primary Care Provider MUST be contacted prior to contacting North Alabama Community Care for a billing referral.  North Alabama Community Care can provide a referral if the PCP refuses to complete a referral.

    • If no PCP is attributed, complete Form 362

  • You must include the following information:

    • Recipient's name, address, telephone, and Parent/Guardian name(s)

    • Recipient's Medicaid number

    • Recipient's date of birth

    • Date referral begins (date of covered visit, procedure, etc.)

    • Consultant's name (Provider requesting referral)

    • Consultant's address

    • Consultant's telephone number

    • Consultant's fax number

  • On your cover sheet, please include justification of need for multiple visits.  For example, multiple physical therapy visits or chemo treatments within one week.

  • Please fax the referral to (256) 382-2715 or email to

Please allow 72 hours, not including weekends, to process the referral. If you have any questions regarding the referral, please call (256) 382-2590 or toll-free (855) 640-8827.

Please inform the Recipient of the need to be linked with a PCP for future referrals and that North Alabama Community Care will contact them to assist with this process.

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