Welcome to Health Information Designs' Alabama Medicaid Prior Authorization Web site.
On this site you will find all of the forms needed to request a Prior Authorization. Please download the proper form, and fill it out COMPLETELY. You can fax the completed form to 1-800-748-0116, or e-mail it to firstname.lastname@example.org. If you need further assistance, please contact us at 1-800-748-0130.
For other information regarding Alabama Medicaid, click here.
Most of the documents on this site are in .pdf format. In order to download and print these documents correctly, we recommend downloading and installing the latest version of Adobe Acrobat Reader.
New Form Submission: