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Your Information Hub for the New MMIS

Arkansas Medicaid providers and beneficiaries rely on a Medicaid Management Information System (MMIS) for provider enrollment, beneficiary eligibility and claims processing. Check this page often for the latest information about the new MMIS. The success of the new MMIS depends on your satisfaction as an Arkansas Medicaid provider.

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Page Contents

Our Provider Assistance Center and EDI Support Center are open from 6:00 a.m. to 6:00 p.m. Monday through Friday. EDI, PAC, Provider Enrollment, and AIPT share the same convenient phone numbers:
(800) 457-4454 in-state toll-free or
(501) 376-2211 local and out-of-state.

If you need to call the EDI Support Center for assistance, please have the person most familiar with the electronic billing and expected responses call with the following information to expedite research:

  • Your provider number(s)
  • Your trading partner number(s)
  • Your method of submission – portal, PES, upload via the portal or secure website, vendor system/billing company/clearinghouse

Immediate Notifications

Notifications at a Glance

HCBS Provider Workshop
NPI Required on Paper Claims
Changes to the Arkansas Medicaid Website
Paper Remittance Advices Will No Longer Be Mailed
Issue With Edit 1019 Resolved
Late Implementation of NCCI Quarterly Files and Claim Adjustments
Corrected Sixty Day Notice for Medicaid Inactivity
Billing Medicaid for Services Not Covered By Other Insurance
NET Providers using Billing Vendors (NET EDI – X12 Field BHT06)
Replacement 1099s
ARChoices Waiver Services Provided on Day of Admission to Institution
How to Link Your Trading Partner ID
Crossover Claims Pricing Update
Dental Prior Authorization Request Transition
Hospital Providers
Patient Control Number – 276 Transaction
Claim Submission Cutoff
Primary Care Physician Provider Action Needed – Changing Service Counties/Regions
Prior Authorization Requests
Rendering Provider Denials
RSPMI PA Denials
MC IDs/Old Submitter IDs
Rehabilitation Centers (RSPMI - Provider type 26 with specialty R6 - Rehabilitation Services for Mental Illness)
Hospice in Long Term Care Claims
Locating Your New Remittance Advices
Institutional Providers – Using NPI and Medicaid Provider ID Rather Than License Number
All Providers – Adjustment of a Paid Claim Request via 837 Transaction
Searching for Legacy MMIS claims in the Portal
Clarification of Trading Partner Linking
Processing Time Between Trading Partner ID Enrollment and EDI Submission
Claim Search
PES Submitters Acknowledgement
RSPMI Providers using Billing Vendors (RSPMI EDI – X12 Field BHT06)
Trading Partner – Referring Provider Update

HCBS Provider Workshop

Added 4/19/18
AFMC will host a HCBS Provider Workshop Tuesday, May 1. The morning session is on ARChoices and the afternoon session on LivingChoices. Get more information and register now!

NPI Required on Paper Claims

Added 4/13/18
If you are required to have a NPI, you must use it when filing paper claims. Electronic claims already require NPIs according to X12 standards. Paper claims must now have a NPI for fields Referring Provider number, Rending Provider number and Billing Provider number. Provider types NOT required to have a NPI may use their Arkansas Medicaid Provider ID.

Changes to the Arkansas Medicaid Website

Updated 4/12/18
Due to changes implemented by the Department of Information Services, the Arkansas Medicaid website URL changed on 4/6/18 from the legacy https://www.medicaid.state.ar.us/ to the new URL https://medicaid.mmis.arkansas.gov/. The legacy Arkansas Medicaid URL will automatically redirect to the updated website URL for a period of time; however, your bookmarks to the website should be updated during this period. In a few months the legacy Arkansas Medicaid website URL will no longer exist and you will receive a page not found message.

Although you should expect a different look for the Arkansas Medicaid website that utilizes a new drop-down menu structure, the content on the Arkansas Medicaid website remains the same.

Paper Remittance Advices Will No Longer Be Mailed

Added 4/6/18
Effective April 30, 2018, Arkansas Medicaid will no longer print and mail paper Remittance Advices (RAs). Providers have two options to receive their RAs:

  • Register on the HealthCare Provider Portal and download your RA using Search Payment History, or
  • Obtain an 835 transaction from your billing vendor, which contains the data from your RA

If you need help registering for the portal, obtaining a trading partner ID, linking your trading partner ID or using Search Payment History, the following job aids will provide step-by-step instructions.

If you have any questions, please contact the Provider Assistance Center at (800) 457-4454 or (501) 376-2211.

Issue With Edit 1019 Resolved

Added 4/5/18
A system update has been applied to correct the issue where DDS claims denied erroneously for edit 1019 – DDS: Fund Code Invalid or Not on File. All DDS claims that denied for edit 1019 from 3/28/2018 thru 4/5/2018 will be resubmitted for processing. Providers do not need to re-submit these claims.

Late Implementation of NCCI Quarterly Files and Claim Adjustments

Updated 3/29/18
CMS mandates the rules for processing Medicaid claims for the National Correct Coding Initiative (NCCI). Per CMS, if a state has not implemented the new quarterly Medicaid NCCI edit files in its MMIS by the first day of the second month of the new calendar quarter, then the state must reprocess with the new quarterly Medicaid NCCI edit files all claims processed with the Medicaid NCCI edit files from the previous calendar quarter on and after the first day of the new calendar quarter until the date the new quarterly Medicaid NCCI edit files for the new calendar quarter are implemented in its MMIS.

During the implementation of the new MMIS system, NCCI Quarterly files were loaded to the system late on two occasions for which claims had to be adjusted so they would reprocess against the correct NCCI quarterly file. These processes require no additional action by you, the provider.

  • On January 10, 2018 claims that are subject to NCCI editing were adjusted to be processed through the correct Q3 2017 NCCI edits.
  • On February 19, 2018 claims that were subject to NCCI editing were adjusted to be processed through the correct Q4 2017 and Q1 2018 NCCI edits.

Corrected Sixty Day Notice for Medicaid Inactivity

Updated 3/9/18
Corrected notifications of cancellation for Medicaid billing inactivity have been mailed to appropriately inactive providers. These corrected notifications are dated February 23. If you received this corrected notification of cancellation, your Medicaid provider ID will be cancelled for inactivity as stated.

Billing Medicaid for Services Not Covered By Other Insurance

Added 3/7/18
If you are a provider of services to a Medicaid eligible Member, but the services you provide are not covered by the Member’s primary insurance company, please see below for documentation and billing guidelines.

  • What documentation do providers need to keep on file as proof they have billed the primary insurance company?
    A provider can use either a certificate of benefits or a denial letter from insurance company (EOB with no payment to provider) or a payment to the provider (EOB with payment). They will need to keep this in the client file for auditing purposes.
  • How long is this denial/EOB good for?
    It will be good for 1 year for either the Certificate of Benefits or Denial EOB.
  • How exactly should this be billed on the claim so that the claim will bypass the TPL editing?
    Example: Get certificate or denial dated 01/01/2018. The provider could use it through 12/31/2018. They would say yes they billed the insurance using a denial date of in this example 01/01/2018 and $0.00 payment amount. Be sure to include Claim Filing Indicator.

NET Providers using Billing Vendors (NET EDI – X12 Field BHT06)

Added 3/7/18
If you use a billing vendor, your encounters may be misinterpreted in the new system causing them to DENY unless X12 field “BHT06” has the value “RP.”

In the legacy MMIS, encounters processed with a value of “CH” in this field; however, this value will may cause a denial in the new MMIS. Please make certain your billing vendor knows the BHT06 field values:

  • RP = Report encounter
  • CH = Claim for payment

The legacy system translator did not consider field BHT06 when accepting claims. The new MMIS translator DOES consider field BHT06. This issue MUST be addressed or your encounters will be marked as claims for payment.

Replacement 1099s

Added 3/1/18
If your paper 1099 form mailed from Arkansas Medicaid has been lost or misplaced, you can print a replacement from the HealthCare Provider Portal. To access your 1099, select “Financial 1099 History” under Category for File Download. Enter 01/01/2018 as the From Date and 03/01/2018 as the To Date. Each 1099 file will start with characters LOD.FIN.TX07 at the beginning of the file name. These 1099 documents are generated by provider number. To know what information was reported to the IRS, you will need to get ALL 1099s for each provider number reported under your tax ID number.

ARChoices Waiver Services Provided on Day of Admission to Institution

Added 1/31/18
If ARChoices Waiver services are provided for a beneficiary on the day the beneficiary is admitted to an inpatient facility, the ARChoices Waiver provider can potentially be paid for services which were provided prior to the client's inpatient admission.

The initial billing for payment will not process through Interchange; however, once notification of non-payment is received by the provider, the claim can be re-submitted on paper (red ink claim) along with supporting documentation for special handling. The documentation must contain information verifying the date, time and services that were provided. The documentation must be signed by the person who provided the service(s) and a contact phone number is required so DHS staff can verify verbally, if necessary.

The claim and documentation should be sent to
Division of Provider Services and Quality Assurance
PO Box 1347, Slot S530
Little Rock, AR 72203-1437

How to Link Your Trading Partner ID

Updated 1/17/18
You can now link your trading partner ID on the HealthCare Provider Portal. View or print the new job aid to learn how to link your trading partner ID. (PDF, new window)

Crossover Claims Pricing Update

Updated 1/11/18
Inpatient Crossover Claims
The new MMIS prices and pays inpatient crossover claims a little differently than the legacy system. The legacy MMIS paid coinsurance plus deductible for all crossover claims. The new MMIS pays the difference between the Medicaid Allowed amount and the Medicare Paid amount, up to but not exceeding the coinsurance plus deductible amount. Crossover claims will post an EOB 9915 – Pricing Adjustment – Medicare crossover claim cutback applied when the amount paid is adjusted to not exceed the coinsurance plus deductible amount.

Professional and Outpatient Crossover Claims
Professional and Outpatient crossover claims are still priced and paid according to coinsurance and deductible amounts.

Dental Prior Authorization Request Transition

Added 1/5/18
Dental Prior Authorization (PA) requests with a Date Of Service (DOS) before 12/31/17 must be sent to
Arkansas Department of Human Services Dental Unit
PO Box 1437 Slot S410
Little Rock, AR 72203

Dental PA requests with a DOS on or after 1/1/18 must be submitted to the appropriate Managed Care Organization (MCO).

PA requests will be returned to providers if

  • the requests are submitted to Arkansas Medicaid without the date of service indicated, or
  • the requests cannot be reviewed by 1/22/18 due to high volume of PA requests.

PA requests returned to the provider must be resubmitted to the respective MCO.

Hospital Providers

Added 12/13/17
The Explanation of Benefit (EOB) were not active for crossover claims, which has caused issues during claims processing. This issue has caused the claims to suspend and subsequently not appear on your Remittance Advice statement. Both EOBs will be active the week of 12/18/17, all claims currently in suspense status will be recycled and should begin to appear the week of 12/25/2017.

  • EOB 0147 – Procedure/Revenue code missing or invalid
  • EOB 0152 – NDC/Procedure/Revenue Codes are not on file

Patient Control Number – 276 transaction

Added 12/12/17
If you are submitting a patient control number on 276 transactions, you must send the REF segment with a qualifier of “EJ” along with the patient control number. If you do not wish to indicate a patient control number, then you need to leave off this segment from your transaction. The REF segment with the patient control number is not a mandatory or required segment. However, if you send the REF segment with REF01=EJ and you leave off patient control number in REF02, this will cause a compliance error. Please get with your software vendor to ensure you are doing this correctly.

Claim Submission Cutoff

Updated 11/30/17
Claims must be submitted by 6:00 p.m. each Friday in order to be included in the weekly financial cycle. Your claims must be included in the financial cycle to pay the following week.

For Pharmacy claims processed by Magellan, the claims submission cutoff is midnight each Thursday.

Primary Care Physician Provider Action Needed – Changing Service Counties/Regions

Added 11/30/17
In an attempt to have the correct Primary Care Physician information on file, we are requesting that the PCP Agreement (Word, new window) be completed by PCPs who are changing service counties/regions or changing who will receive the Managed Care fee payment. Be mindful that if you remove a county/region and you have a patient currently assigned to you in that region, the patient will be unassigned. Please fax the form to (501) 374-0746.

Prior Authorization Requests

Updated 11/16/17
Prior authorizations requests that should go to AFMC are being incorrectly entered into the HealthCare Provider Portal. These requests will not be processed through the portal and MUST go to AFMC for processing as usual. If you request your PA type through Beacon Health or AFMC, you will continue to use same process.

Only the following PA types are available on the portal:

  • 101 – Personal Care
  • 102 – Private Duty Nursing
  • 103 – Adult Dental
  • 104 – Child Dental
  • 105 – Orthodontics
  • 108 – Augmentative Communication Device Evaluation
  • 109 – Disposable Medical Supplies
  • 110 – Home Health Visit Extensions
  • 111 – Other prosthetics
  • 112 – Other medical service – use this process type for Hearing Services PAs
  • 114 – Specialized Service
  • 115 – IndependentChoices
  • 116 – Vision
  • 150 – DDS/ACS waiver
  • 151 – DDS services
  • 152 – Developmental Rehab Services
  • 153 – Title V
  • 154 – First Connections

Rendering Provider Denials

Added 11/14/17
If you are experiencing denial for Rendering Provider NPI, check to see if one of these scenarios will resolve your issues:

  • A denial can occur if a provider’s NPI is not linked to their Arkansas Medicaid provider ID number. If you are receiving denials, then please complete the NPI reporting form (Word, new window), and fax it to DXC to create the link. Once your NPI and Medicaid ID have been linked, your claims can be resubmitted.
  • If your rendering provider does not have an NPI because they are not a “medical” provider (i.e., a teacher), then you would leave the rendering provider field blank. You must leave it blank in both the header and detail of the claim to bypass this edit.
  • RSPMI providers whose rendering providers have not yet enrolled have been given permission to leave both the header and detail blank to bypass this edit until their rendering providers have enrolled and their NPIs are linked.

RSPMI PA Denials

Added 11/14/17
The issue identified for RSPMI providers with claims denying for 399 – Prior Authorization not on file has been fixed. This is for RSPMI claims for revenue codes 0114, 0124, 0128, and 0129. These claims can now be resubmitted.

MC IDs/Old Submitter IDs

Added 11/14/17
Many providers have been billing with PES using their old submitter ID (MC ID). You will NOT receive a response from PES if you are using your old submitter ID. Please validate you are using your new Trading Partner ID (TP01#) and not your former Submitter ID (MC0#) in the PES set-up Options Web Logon ID field pictured below:

Rehabilitation Centers (RSPMI - Provider type 26 with specialty R6 - Rehabilitation Services for Mental Illness)

Updated 11/13/17
Claims submitted and processed in the new Arkansas MMIS with rendering providers who are NOT enrolled in the Arkansas Medicaid program are denying for multiple Explanation of Benefits (EOBs) .

Current policy requires rendering providers to either be fully enrolled as a participating provider or as a registered, non-credentialed provider. If you have previously registered your participating provider, please make certain their NPI is on file with Arkansas Medicaid. To verify the status of their NPI, you may call Provider Enrollment at (800) 457-4454. Select option 0 for “Other Inquires” and then option 3 for “Provider Enrollment” when prompted.

To expedite payment until the rendering providers are enrolled or registered, RSPMI providers may remove the rendering provider ID/Name from the claim and resubmit. This will allow the claim to bypass the denials for rendering provider and give rendering providers time to submit their enrollment applications.

To prevent a duplicate claim denial for subsequent claims on the same date of service (DOS), all procedures provided on the same DOS to a single beneficiary must bill on a single claim detail line.

This workaround is for RSPMI ONLY. Outpatient Behavioral Health Services billing providers are expected to have their rendering providers enrolled and to complete the rendering provider field.

Hospice in Long Term Care Claims

Added 11/7/17
Hospice providers must put the facility ID in the correct facility field for hospice claims to price correctly when a member is in a LTC facility.

  • Web Portal: Enter the facility ID NPI in the Institutional Provider ID field.
  • PES: Enter the facility ID NPI in the Facility ID field.
  • EDI: Enter the facility ID NPI in Loop ID – 2310E Service Facility
  • Paper: Enter the facility ID NPI or MCD in field 78 Other.

Locating Your New Remittance Advices

Updated 11/6/17
Are you having trouble finding your RAs on the new HealthCare Provider Portal? There's a job aid to help! View or print the Search Payment History job aid. (PDF, new window)

When searching for RAs on the portal, providers should enter the Monday through Friday date range for that week’s RA. The Provider Portal uses the issuance date to locate the RA. If a provider receives a paper check, then the RA will be issued on a Thursday. If the provider receives EFT, the issuance date for the RA is Friday.

Institutional Providers – Using NPI and Medicaid Provider ID Rather Than License Number

Added 11/3/17
When submitting provider identification numbers in fields such as attending, operating, or facility ID, on an 837I electronic transaction providers must enter the NPI rather than a license number. For paper claims, the NPI or Medicaid Provider ID is acceptable but not a license number. If the claim is submitted with a license number in any of the provider ID fields as noted above the claim will be denied.

Note: The billing ID must always be an NPI on all institutional claims.

All Providers – Adjustment of a Paid Claim Request via 837 Transaction

Added 11/3/17
Electronic 837 transactions submitted for paid claim adjustments that contain ICNs from the Arkansas Legacy MMIS have erroneously denied for Explanation of Benefit (EOB) 1026 – Original ICN Not Present on 837 or Not Found in History. The DXC Technology team has corrected this issue and will be reprocessing. Please monitor future alerts for additional information on progress of this issue. Going forward, it is critical for providers to use the most current ICN when requesting paid claim adjustments or general inquiries.

Searching for Legacy MMIS claims in the Portal

Added 11/3/17
With the implementation of the new Arkansas MMIS claim-processing system, seven years of information on claims processed in Legacy MMIS were converted to the new Arkansas MMIS. Providers can access information on past claims through the new HealthCare Provider Portal. When logged into the Portal, delegates who have been assigned the Claim Inquiry function can navigate to Claims, select Search Criteria, and enter the relevant information to search for a claim.

Although claim information will be available in the Portal, claims processed in Legacy MMIS that were converted to New Arkansas MMIS will have new claim identification numbers (Claim IDs); the internal control numbers (ICNs) assigned by Legacy MMIS will not be used. Providers will not be able to search for claims processed in Legacy MMIS using the old ICNs. Other search criteria will be required to retrieve claim information. After a claim is identified in the new system, providers are encouraged to record the new Claim ID, as needed, for later reference. Use search criteria such as Beneficiary ID, Service ‘From and To’ and Claim Type in the Portal to find claims processed in Legacy MMIS that have been converted into the new Arkansas MMIS. Remember to use the most current ICN for the claim when requesting and adjustment or performing and inquiry.

Clarification of Trading Partner Linking

Updated 11/3/17
Providers should call the EDI Help Desk to request and consent to be linked to a given Trading Partner ID. DXC Technology must have a provider’s authorization to create a link between their Medicaid ID and their Trading Partners’ IDs.

Processing Time Between Trading Partner ID Enrollment and EDI Submission

Added 10/31/17
When a Trading Partner enrolls for a new ID, there is a delay of up to five days before the Trading Partner ID is activated in the new MMIS. This delay enables staff to certify the trading partner’s file processing and ensure activation in multiple applications that support EDI file processing (standard HIPAA-compliant transaction files).

Claim Search

Added 10/27/17
If you are doing a claim search in the portal or through the Voice Response, you must use the most current Medicaid beneficiary ID number. If you are not certain that you have the current beneficiary ID number or you cannot locate a claim you know has been accepted, denied or suspended, then verify eligibility using the beneficiary’s name and date of birth. This search method will allow you to find the beneficiary’s most current ID number. You can then perform the claim search using the most current beneficiary Medicaid ID number.

PES Submitters Acknowledgement

Added 10/27/17
For submitters using PES, you will receive a 999 functional acknowledgement for all batch submissions.

RSPMI Providers using Billing Vendors
(RSPMI EDI – X12 Field BHT06)

Added 10/27/17
If you use a billing vendor, your claims may be misinterpreted in the new system causing them to DENY unless X12 field “BHT06” has the value “CH.”

In the legacy MMIS, some claims have processed with a value of “RP” in this field; however, this value will cause a denial in the new MMIS.

Please make certain your billing vendor knows the BHT06 field values:

  • RP = Report encounter
  • CH = Claim for payment

The legacy system translator does not consider field BHT06 when accepting claims. The new MMIS translator DOES consider field BHT06. This issue MUST be addressed immediately or your claims will be marked as encounters and will NOT PAY.

Trading Partner – Referring Provider Update

Added 10/26/17
This information pertains to trading partners – vendors, clearinghouses or billing companies. Providers who are aware of these types of denials should contact and refer their trading partners to this notification.

We are seeing a high HIPAA Compliance X12 failure rate for claims that require the Referring Provider. Both the First Name and the Last Name must be populated; some Trading Partners are leaving one field or the other blank. The following applies:

  • 837I – 2310F loop (Referring Provider First and Last Name must be populated)
  • 837P – 2310A loop (Referring Provider First and Last Name must be populated)
  • The qualifier in NM102 must be a 1 (Person) not a 2 (Organization)

Note 1: The Guides indicate it is supposed to be a person, but we understand that some are actually entities.
Note 2: The text in the fields is NOT examined; therefore, the contents can be whatever the Submitter determines is appropriate.

Ensuring both fields are populated will allow the claims to get past this compliance error. We are updating our Companion Guides to include this information as well.

MMIS Job Aids

Training Materials File Name File Size
Eligibility Verification MMIS_JobAid_Eligibility.pdf 1.5MB
MAPIR MMIS_JobAid_MAPIR.pdf 1.2MB
Prior Authorization MMIS_JobAid_PriorAuthorization.pdf 2MB
Registering on the Provider Portal – Provider MMIS_JobAid_ProvPortalReg.pdf 6.1MB
Registering on the Provider Portal – Delegates MMIS_JobAid_DelegatePortalReg.pdf 4.4MB
Registering on the Provider Portal – Trading Partners MMIS_JobAid_TradingPartnerPortalReg.pdf 2.1MB
Frequently Asked Questions Regarding Registering on the Portal MMIS_JobAid_PortalRegFAQs.pdf 76k
Trading Partner ID Enrollment MMIS_JobAid_TrdngPrtnrIDEnroll.pdf 2.8MB
How to Link Your Trading Partner ID MMIS_JobAid_LinkTPID.pdf 1.9MB
Frequently Asked Questions for Trading Partner ID Enrollment MMIS_TradingPartnerEnrollFAQ.pdf 75k
Search Payment History MMIS_JobAid_SearchPaymentHistory.pdf 946k
Submitting and Reviewing a Claim MMIS_JobAid_SubmittingReviewingClaim.pdf 3.4MB
How to Check Claim Status MMIS_JobAid_CheckClaimStatus.pdf 1MB
Treatment History MMIS_JobAid_TreatmentHistory.pdf 1.5MB
Updating PCP Caseload MMIS_JobAid_UpdatingPCPCaseload.pdf 1.4MB
Uploading Documents MMIS_JobAid_UploadingDocuments.pdf 1.1MB
Using the new Medicaid Provider Portal PortalTraining.pdf 15MB

If you would like to learn more about the new MMIS, AFMC is hosting a series of webinars. View a webinar today!


Go to Arkansas Medicaid         dxc.technology

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