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Alabama Medicaid

Welcome to Acentra Health's Alabama Medicaid
Prior Authorization Website.

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 al_pa@acentra.com. 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

You can now fill out and submit your Prior Authorization and Override requests online.

Submit Request Online

Contact Us
al_pa@acentra.com
P: 1-800-748-0130
F: 1-800-748-0116

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