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As the threat from COVID-19 continues, important information on what DHS is doing about coronavirus as well as reliable, up-to-date information about how the virus is affecting the State can be found on the DHS website.
The Provider-led Arkansas Shared Savings Entity (PASSE) is a new model of organized care that will address the needs of certain Medicaid beneficiaries who have complex behavioral health and intellectual and developmental disabilities service
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Timely Information from Arkansas Medicaid
Recoupment Due To Missing Procedure Codes T1015 And 97750 For Audit 5202 History Claim Configuration — Claims Paid Incorrectly
Audit 5202 (Exceeds limit of 12 outpatient visits per State Fiscal Year (SFY)) was missing two procedure codes (T1015 and 97750) in the configuration for the claim history for claims processing. This is a limitation audit. Claims have paid incorrectly. The identified claims will be recouped.
T1015 - CLINIC VISIT/ENCOUNTER, ALL-INCLUSIVE
97750 - PHYSICAL PERFORMANCE TEST OR MEASUREMENT WITH REPORT, EACH 15 MINUTES
Action Required - Electronic Visit Verification (EVV) System Training
ARChoices and Personal Care Providers: Section 12006(a) of the 21st Century Cures Act mandates that states implement Electronic Visit Verification (EVV) for all Medicaid personal care services (PCS) that require an in-home visit by a provider. These services include Personal Care, Attendant Care, and Respite provided under the Medicaid State Plan and under Home and Community Based Services waivers to individuals in the home.
DHS has partnered with Fiserv to offer a State-sponsored EVV system, called AuthentiCare. By now you should have selected to use either AuthentiCare or a third-party vendor for your EVV system. Training is required regardless of which system you chose.
If you have not yet registered for training sessions, please do so immediately. All of your caregivers will need to be trained prior to system go-live on December 4, 2020. You should have received an email with training information and registration URLs. If you did not receive this email, please contact: EVVarkansas@dhs.arkansas.gov.
- Training consists of the following virtual modules for AuthentiCare users: Train-the-trainer, mobile application, web application, reports, and IVR (Interactive Voice Response)
- Training consists of the following virtual modules for third-party users: Web application and reports
Additional training information, as well as registration URLs, have been sent to the email address that is on file. If you did not receive an email regarding EVV training, please contact: EVVarkansas@dhs.arkansas.gov.
Claims with Span Dates When the COVID-19 Effective Date (4/15/2020) is within the Span Date
If you have a service which previously required a Prior Authorization, and currently is not required due to COVID-19 please be aware of how to bill your claim if it has span dates.
COVID-19 Testing Effective Date is 4/15/2020. So, if you have a claim which previously required Prior Authorization for a service, but no longer does due to COVID-19 and the dates of service span through the COVID-19 Effective Date you need to split bill the claim.
Claim 1 Example:
Date Span is 4/1/2020 - 4/30/2020. This spans the COVID-19 Effective Date and needs to be split billed into two claims. One prior to the COVID-19 Effective Date and one after the COVID-19 Effective Date.
New Claim 1A - Prior to the COVID-19 Effective Date
DOS - 4/1/2020 - 4/14/2020
New Claim 1B - On and after the COVID-19 Effective Date
DOS - 4/15/2020 - 4/30/2020
Claim 2 Example:
Date Span is 3/23/2020 - 4/22/2020. This spans the COVID-19 Effective Date and needs to be split billed into two claims. One prior to the COVID-19 Effective Date and one after the COVID-19 Effective Date.
New Claim 2A - Prior to the COVID-19 Effective Date
DOS - 3/23/2020 - 4/14/2020
New Claim 2B - On and after the COVID-19 Effective Date
DOS - 4/15/2020 - 4/22/2020
The following procedure code is now available for CLIA waivered pharmacists with PV specialty*, in billing of COVID-19 antigen detection testing. This code will be retroactive to dates of service June 25, 2020, and forward.
*CLIA waiver and PV specialty must be current and submitted to provider enrollment.
Procedure Code: 87426, Modifier: QW, Fee: $45.23 (total)
Short Description: Coronavirus AG IA
Long Description: Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
Current Demonstration Waiver Projects
The Division of Medical Services will provide public notice and allow input processes for its intent to submit written applications, renewals or amendments to any 1115(a) demonstration waiver projects that will be sent to the Centers of Medicare
and Medicaid Services. Learn more about current demonstration waiver projects.
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