Alabama Parity Resources

For general information about filing a parity appeal for mental health or addictions services, you cannot go wrong with contacting one of the consumer advocates below. Each has years of experience helping consumers in the state of Alabama. Contact your insurance company first, if no response:

Alabama Department of Insurance
Consumer Services Division
PO Box 303351 Montgomery, AL 36130-3351
(334) 241-4141

State of Alabama Attorney General
Consumer Hotline: 1-800-392-5658 or 334-242-7335
Click here for complaint form.

Alabama Medicaid
Hotline for Assistance 800-362-1504
http://www.medicaid.alabama.gov

When filing an appeal for the first time, you should contact your health plan’s customer service support line or check out their information online. If you choose to appeal an adverse benefit determination concerning your mental health or substance use treatment or benefits, please keep in mind that the timeframe to do so varies by state, plan type, and other factors. Contact your state’s department of insurance for additional information. Here is some contact information for Alabama Health Plans:

Blue Cross Blue Shield of Alabama
Customer Service: Members should use the telephone number on the back of the ID card. If your card is unavailable, use the following numbers Federal Employees: 800-492-8872 All other members :(800) 292-8868

United Healthcare of Alabama
Customer Service: Telephone numbers can be found on the back of the ID card.
33 Inverness Center Parkway Ste 320 Birmingham, AL 35242
800-345-1520

VIVA HEALTH, INC
417 20th Street North, Ste 1100 Birmingham, AL 35203
800-633-1542

Insurance Commissioner

Alabama Department of Public Health, Division of Managed Care Compliance
Commissioner
201 Monroe Street, Suite 710
Montgomery, AL 36104
Phone: (334) 269-3550
Fax: (334) 241-4192

Utilization Management Appeals

Alabama Department of Public Health, Division of Managed Care Compliance
Director, Division of Healthcare Facilities
201 Monroe Street, Suite 710
Montgomery, AL 36104
Phone: (334) 205-5998
Fax: (334) 206-2067

External Review Appeals

Alabama Department of Public Health, Division of Managed Care Compliance
Director, Division of Healthcare Facilities
201 Monroe Street, Suite 710
Montgomery, AL 36104
Phone: (334) 205-5998
Fax: (334) 206-2067

Parity Appeals

Alabama Department of Public Health, Division of Managed Care Compliance
Director, Division of Healthcare Facilities
201 Monroe Street, Suite 710
Montgomery, AL 36104
Phone: (334) 205-5998
Fax: (334) 206-2067

Additional Alabama Insurance Administration Contacts, click here.

The federal government also can be a helpful resource if you are enrolled in a self-funded plan, Medicare, Medicaid or another type of insurance that is overseen at least in part by a federal agency.

For definitions and filing information refer to the Parity Resource Guide

U.S. Department of Health and Human Service’s website on the Affordable Care Act health reform law

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA)

(SAMHSA) Implementation Mental Health Parity Addiction Equity Act

U.S. Centers for Medicare and Medicaid Services (CMS)

U.S. Department of Labor, Employee Benefits, Security Administration (EBSA) or toll-free hotline: 1.866.444.EBSA (3272)

For the U.S. Department of Health and Human Services & Centers for Medicare and Medicaid Services list of exempt state and local plans, please email NonFed@cms.hhs.gov. You may ask them if any particular state and local plan has opted out of MHPAEA.

Information on requirements of employer-based insurance coverage and self-insured health plans.
EBSA has benefit advisors who are available to answer questions and provide assistance in obtaining your benefits.

Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits

Veterans and military personnel can use these resources to get help or more information with their medical or behavioral health complaints.

Health Net Federal Services

A grievance is a written complaint or concern about a medical provider.
Click here for specific information regarding who, what and how to file.

TRICARE

View the recently released Tricare Mental Health Fact Sheet.

The appeal process is different based on the benefit issue. Depending on your issue, you can file a:

• Factual appeal
  • This is if you were denied payment for services or supplies you received, or if payment was stopped for services or supplies previously authorized.
• Medical necessity appeal
  • This is if prior authorization for care or services was denied because it was not deemed medically necessary. Medically necessary means it must be appropriate, reasonable, and adequate for your condition.
• Pharmacy appeal
  • This is if you don’t agree with a decision made about your pharmacy benefit. For example, Express Scripts denies your pharmacy claim.
• Medicare-TRICARE appeal
  • This is if you’re eligible for both TRICARE and Medicare, and Medicare denies your services or supplies.

If your care is denied, you should receive a letter with details about how to file your appeal.

Veterans Health Administration

Complaints are initially handled through the Patient Advocate.
Patient Advocate can be contacted at your local VA Medical Center.

If you have any additional questions about parity compliance, please contact info@paritytrack.org