Help Desks / Support Centers

(800) 457-4454
in-state toll-free or
(501) 376-2211
local and out-of-state

Arkansas Payment Improvement Initiative
(866) 322-4696 in-state toll-free or
(501) 301-8311 local and out-of-state

Magellan Medicaid Administration Pharmacy Help Desk
(800) 424-7895, Option 2 for Prescribers

What’s New for Arkansas Medicaid Providers

Smiling dental provider

Content updated May 22, 2019

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Enrollment for DME Providers to Bill Specialty Waiver Products

Current Prosthetic (DME and Orthotics) providers are needed to meet needs of beneficiaries enrolled in the Arkansas Provider-led Arkansas Shared Savings Entity (PASSE) Program. Services that will be rendered under this program may include (but are not limited to) the ordering, and delivery of specialized medical supplies, physical aids or adaptive equipment to a beneficiary in accordance with their Person Centered Services Plan (PCSP) as authorized through the PASSE program utilization review process.

View or print the letter for full details regarding the enrollment process. (Word, window)

Global OB Claims

This is notification that a systematic workaround has been identified to process claims that have denied due to Member’s Benefit Plan changing during the Global OB period. Currently, please continue to bill your claims as you always have.

Within the next month, the first reprocessings will take place of the current backlog of claims that have denied for this reason. After this initial reprocessing, regular reprocessings will occur the 15th of every month for all those claims that have denied within the previous month.

Current plans are in place for a permanent fix to this issue to be implemented by January 1, 2020. However, again, please continue to bill today as you have in the past. More communication will be sent when changes are needed to your current billing process.

New Provider Workshop/Webinar

Join AFMC for the upcoming new provider workshop/webinar on Wednesday, June 5. Learn more now!

2019 CEHRT Requirements

Added 4/18/19
The 2015 Edition CEHRT does not have to be implemented on January 1, 2019. However, participants must use the functionality of the 2015 Edition CEHRT for a minimum of any continuous 90-day EHR reporting period in 2019. The EHR must be certified to the 2015 Edition standards and certification criteria by the FIRST day of the selected EHR reporting period.

2015 CEHRT Requirement Fact Sheet Clarification

Added 4/18/19
CMS released new resources for the Promoting Interoperability Program.

Streamlined Arkansas Medicaid Revalidation Available for Providers Enrolled in Medicare

Added 4/17/19
CMS has established guidelines allowing providers enrolled in Medicare and Medicaid to be revalidated through a streamlined process. In order to qualify, provider information on file with Arkansas Medicaid must match the information in Medicare’s Provider Enrollment, Chain, and Ownership System (PECOS).

Medicaid Provider Enrollment will begin checking PECOS for providers who must revalidate soon. If Provider Enrollment confirms a match between the two systems, revalidation will be processed with no further provider action necessary. To take advantage of this time-saving opportunity, Enrollment encourages providers to keep these important match criteria updated with Arkansas Medicaid and PECOS:

If Enrollment is unable to confirm a match between the two systems, the provider will receive a revalidation letter and be required to submit a full enrollment application to revalidate their enrollment as an Arkansas Medicaid provider.

Change to Outbound/Response File Naming Conventions

Updated 4/15/19
The Arkansas Medicaid EDI X12 outbound and/or response file naming convention is changing beginning on May 29, 2019. Filenames will use the new format [TradingPartnerId]_[ BatchId]_[FileTrackingId].[FileExt].

  1. TradingPartnerId is your 8 character trading partner ID
  2. BatchId is an 8 digit number
  3. FileTrackingId is a 9 digit number
  4. FileExt is one of the following:
    • 271 (271 eligibility response)
    • 277 (277 claim status response)
    • 278R (278 prior authorization response)
    • 835 (835 payment remittance advice)
    • 820X (HIX 820 Private Option premium payments)
    • 820H (HIPAA 820 capitation payments)
    • 834 (834 benefit enrollment)
    • 999 (999 Acknowledgement)
    • TA1 (TA1 Acknowledgement)

Arkansas Works Update

Added 4/1/19
On March 27, a U.S. District Judge based in Washington D.C. ruled on a lawsuit concerning the Arkansas Works (AR Works) work and community engagement requirement. The judge blocked the work and community engagement until further notice. As of this date, the work and community engagement requirement is suspended and beneficiaries will not be required to report work activities to retain their health insurance coverage. Those beneficiaries in AR Works who do not have a work and community engagement requirement will not be affected.

The Division of County Operations has been working to ensure that beneficiaries whose coverage ended this month solely due to non-compliance with the work requirements, will have their Medicaid eligibility reinstated. Beneficiaries will receive a notice by mail informing them of this ruling. These beneficiaries who have their Medicaid eligibility reinstated should be enrolled with their previous insurance carrier by Monday, April 1, and should not experience a disruption in their Arkansas Works coverage. If you have a beneficiary who is experiencing a disruption in their coverage through Arkansas Works or has questions about the court ruling, they can call the DHS helpline at 1-855-372-1084.

Providers should remove any and all posters/flyers or informational materials for the work requirement in your offices while the suspension is in place.

Note: This decision is not suspending the AR Works Program, only the AR Works work and community engagement requirement.

Should you have questions about the Arkansas Works ruling, please reach out to your AFMC Provider Relations Specialist (HTML, new window) for assistance.

IMPORTANT UPDATE:
Entry of Electronic PAs Using AFMC ReviewPoint Portal to Continue

Added 2/28/19
We are continuing to optimize the Arkansas Medicaid Prior Authorization Process to ensure the best possible experience for providers and beneficiaries. Prior Authorization requests reviewed by AFMC should continue to be submitted in the AFMC ReviewPoint Portal (HTML, new window) until further notice.

Although you can enter the DXC portal now and familiarize yourself with the interface, the DXC Provider Portal will formally launch at a later time and you will be informed when to start using the system for actual submission of prior authorization requests and documents. Until then, please continue to use the AFMC ReviewPoint Portal (HTML, new window) for all prior authorization submissions reviewed by AFMC.

PI/MU Deadline for 2018 Attestations

Added 1/25/19
The Arkansas Promoting Interoperability (PI) Program Meaningful Use (MU) deadline for 2018 attestations is 3/31/2019.

Any applications submitted by the 3/31/19 deadline that are assigned PENDING status for further corrections and assistance from AIPT will be given an extended deadline. All pending applications must be fully completed by June 1, 2019.

Electronic Funds Transfer Required for All Providers Billing All Claims

Updated 12/10/18
All providers and groups, excluding providers rendering services under a group, require EFT to enroll in Arkansas Medicaid. Providers participating in the Arkansas Diamond Plan or billing for services as an individual must have EFT on file.

Any claims that are submitted without EFT on file will deny.

For Outpatient Behavioral Health Services Providers
The following providers require an EFT to enroll in Arkansas Medicaid:

  1. Behavioral Health Agency
  2. Independently Licensed Practitioner Individual and
  3. Independently Licensed Practitioner Group

Providers rendering services solely as employees of a Behavioral Health Agency do not require an EFT to enroll in Arkansas Medicaid. Providers participating in the Arkansas Diamond Plan or billing for services as an individual must have EFT on file. Any claims that are submitted without EFT on file will deny.

New RA Messages

Updated 5/21/19
Arkansas Medicaid released an RA message to AHEC, Certified Nurse-Midwife, FQHC, and Physician providers. View the RA message regarding Global OB Claims. (Word, new window)

Added 4/18/19
Arkansas Medicaid released an RA message to all Eligible Hospital and Eligible Professional providers. View the RA message regarding 2019 CEHRT Requirements. (Word, new window)

Arkansas Medicaid released an RA message to all Eligible Hospital and Eligible Professional providers. View the RA message regarding 2019 CEHRT Requirement Fact Sheet Clarification. (Word, new window)