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 March 21, 2019

Jump to

Change to Outbound/Response File Naming Conventions

Updated 3/11/19
The Arkansas Medicaid EDI X12 outbound and/or response file naming convention is changing beginning on May 1, 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)

Provider-led Arkansas Shared Savings Entity (PASSE) UPDATE

Added 3/4/19
Medicaid Providers cannot ask PASSE Medicaid beneficiaries to pay out of pocket or cash for Medicaid services. Cost sharing requirements are not permissible under the PASSE program.

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.

Provider-led Arkansas Shared Savings Entity (PASSE) Will Go Live on March 1, 2019

Updated 2/28/19
The Provider-led Arkansas Shared Savings Entity (PASSE) model of care is a State health plan created to meet the needs of approximately 40,000 Medicaid beneficiaries with complex behavioral health, developmental and/or intellectual disabilities.

Beginning March 1, 2019, you will no longer bill Medicaid for these Medicaid beneficiaries but will instead bill the individual PASSEs. Submitting Fee-For-Service claims for PASSE beneficiaries on or after 3/1/19 will result in denial of the claim.

We encourage you to ENROLL IN ALL THREE PASSEs to ensure you can continue to provide services for your Medicaid clients enrolled in a PASSE. Each PASSE member will receive a new ID card prior to March 1, 2019. This card will have the PASSE logo and will identify to which PASSE the beneficiary belongs. Providers can log into the HealthCare Provider Portal (HTML, new window) beginning February 15 to verify Medicaid eligibility and to find the beneficiary's assigned PASSE.

Who are the PASSEs?

  • Arkansas Total Care – 1-844-631-6830 (option 4)
  • Empower Healthcare Solutions – 501-707-0920 or 501-707-0928
  • Summit Community Care – 1-844-405-4295

Get more information about the PASSE Model of Care at https://humanservices.arkansas.gov/about-dhs/dms/passe (HTML, new window) or contact Tanya Giles, Division of Medical Services, at 501-320-6189.

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 Provider Manual Updates

Added 2/14/19
Arkansas Medicaid released an Outpatient Behavioral Health Services (OBHS) provider manual update. View or print the OBHS-3-18 transmittal letter. (Word, new window)
View or print changes to the OBHS provider manual. (Word, new window)

Arkansas Medicaid released a Provider-Led Arkansas Shared Savings Entity (PASSE) Program provider manual update. View or print the PASSE-1-18 transmittal letter. (Word, new window)
View or print changes to the PASSE provider manual. (Word, new window)

New RA Messages

Added 3/8/19
Arkansas Medicaid released an RA message to all providers. View the RA message regarding Provider-led Arkansas Shared Savings Entity (PASSE) UPDATE. (Word, new window)

Arkansas Medicaid released an RA message to all providers. View the RA message regarding Change to Outbound/Response File Naming Conventions. (Word, new window)

Added 3/1/19
Arkansas Medicaid released an RA message to all providers. View the RA message regarding IMPORTANT UPDATE: Entry of Electronic PAs Using AFMC ReviewPoint Portal to Continue. (Word, new window)

Updated 2/28/19
Arkansas Medicaid released an RA message to all providers. View the RA message regarding Provider-led Arkansas Shared Savings Entity (PASSE) Will Go Live on March 1, 2019. (Word, new window)