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 February 15, 2019

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Entry of Electronic PAs Using AFMC ReviewPoint Portal Ends March 1, 2019

Added 2/7/19
Beginning March 1, 2019, Prior Authorizations (PAs) formerly submitted electronically through the AFMC ReviewPoint portal must be submitted through the Arkansas Medicaid Provider Portal. (Paper and phone PAs will continue to be submitted as they are today.) Providers will continue using the appropriate PA Process Type listed in the Vendor Drop Down on the Managed Care PA page.

Providers must register to begin using the HealthCare Provider Portal (HTML, new window) if they do not currently have access. Providers who use clerical staff to submit PAs in ReviewPoint on their behalf must register them as delegates prior to March 1. View job aids to assist with provider registration and delegate registration.

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

Added 1/30/19
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 – 501-304-5744

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.

ACA Provider Enrollment Fee Amount Set for 2019

Added 1/18/19
Certain provider types are subject to an application fee set by the Centers for Medicare & Medicaid Services (CMS). This federally mandated fee is used to offset the cost of conducting screening activities associated with the ACA. The fee has been adjusted for 2019 to $586.

Medicare Advantage Claims Processing Issue

Added 1/17/19
An issue in the EDI claim intake process specific to Medicare Advantage claims was identified. When a Medicare Advantage claim was submitted with a paid (AMT D) value on 837I input, the EDI intake process should have indicated this amount as Medicare payment. Instead, the system incorrectly considered this amount as another insurer payment (not Medicare) resulting in further cutbacks to payment that should not have occurred. This issue was corrected on January 11. Claims that were processed incorrectly can be adjusted on the Healthcare Provider Portal. For all questions, please contact EDI at (800) 457-4454.

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)

Added 2/13/19
Arkansas Medicaid released the new Adult Behavioral Health Services for Community Independence (ABHSCI) provider manual. View or print the ABHSCI-New-18 transmittal letter. (Word, new window)
View or print the ABHSCI provider manual. (Word, new window)

Added 1/24/19
Arkansas Medicaid released a Ventilator Equipment provider manual update. View or print the VENT-1-19 transmittal letter. (Word, new window)
View or print changes to the Ventilator Equipment provider manual. (Word, new window)

New RA Messages

Added 2/15/19
Arkansas Medicaid released an RA message to all pharmacy providers. View the RA message regarding New CAP Rates. (Word, new window)

Added 2/7/19
Arkansas Medicaid released an RA message to all providers. View the RA message regarding Entry of Electronic PAs Using AFMC ReviewPoint Portal Ends March 1, 2019. (Word, new window)

Added 1/30/19
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)

Added 1/25/19
Arkansas Medicaid released an RA message to Eligible Hospital and Eligible Professional providers. View the RA message regarding PI/MU Deadline for 2018 Attestations. (Word, new window)

Added 1/17/19
Arkansas Medicaid released an RA message to all providers. View the RA message regarding ACA Provider Enrollment Fee Amount Set for 2019. (Word, new window)