SPAY – NEUTER LICENSE PLATE PROGRAM
ENROLLMENT AND REPORTING PROCEDURES
Requirements for hospital enrollment
1. All veterinarians working at hospital must be either members of the ALVMA or have made application to the ALVMA for membership. Applications may be submitted with enrollment information. New veterinarians in the practice are expected to submit application within 90 days of employment for the hospital to continue participation. The veterinary hospital must be located in Alabama.
2. Submit Hospital Enrollment Form signed by all veterinarians in practice.
3. Submit signed W-9 with name and federal number listed exactly as they appear on your income tax return to the IRS.
4. Send enrollment documents to:
ALVMF, S-N Program, P O Box 640279, Pike Road , AL 36064
Qualifications for client participation
1. Must be an Alabama Medicaid recipient. Do not confuse this with Medicare. Medicaid is low-income, whereas Medicare is a program for the elderly.
2. Client must show photo identification matching the name on the Alabama Medicaid card.
3. Client will pay a co-pay of $10 per cat and $20 per dog (collected by you).
4. The Medicaid cardholder must sign surgery form. If cardholder is an invalid or child, parent/guardian may sign for them. Signor must note the relationship category next to his/her signature on the surgery form.
5. Program only pays for two surgeries in a calendar year per household. The client will be eligible for two more surgeries in each successive calendar year. A parent with multiple children on Medicaid will still only qualify for the household limit above.
Logistics of program
1. In order to insure that we have sufficient funds to pay for all submitted surgeries, we must pre-approve the surgeries before you perform them.
2. You may submit this information by fax (334.270.3399) or website. If sufficient funds are available, you will receive a permit number for this particular surgery. The permit number is only to be used for surgery on the animal for which it was issued. You will have 60 days following the pre-approval authorization to submit the request for payment (program reporting form) along with the surgery form, showing that the surgery was performed.
3. If funds are not available at the time of the request, we will hold your request on an “as received” priority basis and notify you as the state makes additional funds available.
4. Your continued efforts in promoting the s/n license plate to your clients and in your community will insure more funds for these efforts.
Monthly Reporting
1. Monthly report will consist of completed original surgery forms, copy of Medicaid card and picture ID for each surgery, and Program Reporting Form.
2. Monthly report is due in this office on the 10th of the month following the surgery. Mail to the ALVMF address noted above.
3. Reimbursement amounts (in addition to the co-pay you collect) are:
a. $80 for cat spay
b. $35 for cat neuter
c. $100 for dog spay
d. $50 for dog neuter
4. Checks will be mailed the last week of the month.
5. Reimbursement and co-pay covers the total fee for anesthesia and surgery, regardless of the patient’s size, stage of estrus, and body condition (pregnant, neoplasia, cryptorchid, etc.) No participant is required to perform a non-routine spay/neuter for the designated fee; however, that is all that may be charged for the designated procedure. Additional requirements for vaccinations and laboratory testing may be addressed on an individual hospital basis, but will not be reimbursed through this program.
If you have any questions, please contact Linda Cargile ([email protected]) or Tara Beasley ([email protected]).
Our phone is 334/513-2993; our fax is 334/513-2993.
1. All veterinarians working at hospital must be either members of the ALVMA or have made application to the ALVMA for membership. Applications may be submitted with enrollment information. New veterinarians in the practice are expected to submit application within 90 days of employment for the hospital to continue participation. The veterinary hospital must be located in Alabama.
2. Submit Hospital Enrollment Form signed by all veterinarians in practice.
3. Submit signed W-9 with name and federal number listed exactly as they appear on your income tax return to the IRS.
4. Send enrollment documents to:
ALVMF, S-N Program, P O Box 640279, Pike Road , AL 36064
Qualifications for client participation
1. Must be an Alabama Medicaid recipient. Do not confuse this with Medicare. Medicaid is low-income, whereas Medicare is a program for the elderly.
2. Client must show photo identification matching the name on the Alabama Medicaid card.
3. Client will pay a co-pay of $10 per cat and $20 per dog (collected by you).
4. The Medicaid cardholder must sign surgery form. If cardholder is an invalid or child, parent/guardian may sign for them. Signor must note the relationship category next to his/her signature on the surgery form.
5. Program only pays for two surgeries in a calendar year per household. The client will be eligible for two more surgeries in each successive calendar year. A parent with multiple children on Medicaid will still only qualify for the household limit above.
Logistics of program
1. In order to insure that we have sufficient funds to pay for all submitted surgeries, we must pre-approve the surgeries before you perform them.
2. You may submit this information by fax (334.270.3399) or website. If sufficient funds are available, you will receive a permit number for this particular surgery. The permit number is only to be used for surgery on the animal for which it was issued. You will have 60 days following the pre-approval authorization to submit the request for payment (program reporting form) along with the surgery form, showing that the surgery was performed.
3. If funds are not available at the time of the request, we will hold your request on an “as received” priority basis and notify you as the state makes additional funds available.
4. Your continued efforts in promoting the s/n license plate to your clients and in your community will insure more funds for these efforts.
Monthly Reporting
1. Monthly report will consist of completed original surgery forms, copy of Medicaid card and picture ID for each surgery, and Program Reporting Form.
2. Monthly report is due in this office on the 10th of the month following the surgery. Mail to the ALVMF address noted above.
3. Reimbursement amounts (in addition to the co-pay you collect) are:
a. $80 for cat spay
b. $35 for cat neuter
c. $100 for dog spay
d. $50 for dog neuter
4. Checks will be mailed the last week of the month.
5. Reimbursement and co-pay covers the total fee for anesthesia and surgery, regardless of the patient’s size, stage of estrus, and body condition (pregnant, neoplasia, cryptorchid, etc.) No participant is required to perform a non-routine spay/neuter for the designated fee; however, that is all that may be charged for the designated procedure. Additional requirements for vaccinations and laboratory testing may be addressed on an individual hospital basis, but will not be reimbursed through this program.
If you have any questions, please contact Linda Cargile ([email protected]) or Tara Beasley ([email protected]).
Our phone is 334/513-2993; our fax is 334/513-2993.
