Timely Information from Arkansas Medicaid
All systems are currently online.
EHR Providers to Avoid Medicare Payment Adjustments (Penalties)
CMS has an alternate option within the CMS registration and attestation system for providers to attest in order to avoid Medicare Payment Adjustments (penalties). This alternate method would allow EPs who previously received an incentive payment under the Medicaid EHR Incentive Program (for either AIU or meaningful use) to demonstrate that they are meaningful EHR users even though they did not meet the eligibility criteria for the Medicaid EHR Incentive Program in a subsequent year. The deadline to attest using this alternative method is 2/29/16. An EP’s attestation using this method would not constitute a switch from the Medicaid EHR Incentive Program to the Medicare EHR Incentive Program and would not fulfill the meaningful use requirement for an incentive payment.
Please contact the Arkansas Incentive Payment Team (AIPT) at email@example.com with questions or concerns.
Issues Resolved with Error Codes 013 AND 036
All issues regarding Errror Code 013/EOB 017 and Error Code 036/EOB 123 have been resolved. Providers may resubmit claims. BILLING REMINDER: For inpatient claims where a delivery condition code is billed, a delivery diagnosis code must be present in the ADMIT Diagnosis field, PRIMARY Diagnosis field, or Diagnosis 1 field. If the delivery diagnosis is not in one of the listed fields, the delivery will not be recognized.
Crossover Billing Forms Clarification
Section V manual update SecV-3-15 concerning inpatient and outpatient hospital crossover billing forms was recently released to providers. DHS has received approval for the payment modification of inpatient hospital crossover claims for dates of service on or after January 1, 2016; however, the system changes have not been implemented. More information will be released when the payment system changes are completed. Hospitals should not change their method of billing for inpatient crossover claims until further notice.
Payment Notice to Provider Types 52 and 96
There was a processing error on claims that were submitted 12/26/2015 through 1/1/2016. This is an isolated event, affecting provider type 52 and provider type 96. The payment for these claims will be delayed one week. The claims will be reprocessed the weekend of 1/9/16 for a pay date of 1/14/16. We apologize for the inconvenience.
December 15, 2015 – EHR - Eligible Professionals — A/I/U ONLY
As of December 15, 2015, providers are unable to attest to MU until MAPIR is updated to include Modified-MU2 measures. Providers may continue to Adopt, Implement, or Upgrade (AIU) in MAPIR if this is their first year participating in the EHR Incentive program. We apologize for any inconvenience this may cause. A notification will be sent as soon as Modified-MU2 can begin.
2015 Eligible Hospital (EH) Meaningful Use Attestation
The submission date for EH Meaningful Use will be announced as soon as possible. At this time, we expect a mid to late 2016 date. We apologize for any inconvenience this may cause.
Calling PAC with ICD-10-Related Issues
In order to expedite your wait time, please have the following information ready when you call:
- MC0* Submitter ID
- Rejection Codes (Edit numbers and EOB numbers)
- ICN (for paper claims)
- Batch number
- Recipient ID number
- Patient account number
Before you call, review the ICD-10 Billing and Compliance Tips that might help you resolve your issue and avoid the call center.
Answers to Arkansas Medicaid providers’ most frequent ICD-10 questions will be posted daily on the Arkansas Medicaid ICD-10 Implementation Information page. To save time, please visit this page and review the FAQ before calling the Provider Assistance Center with your questions about ICD-10 conversion. The answer you need may already be online.
Proposed Extension Application for and Potential Modifications to the 1115 Demonstration Waiver for the Health Care Independence Program
The Arkansas Department of Human Services (DHS), Division of Medical Services (DMS) is providing public notice of its intent to submit to the Centers of Medicare and Medicaid Services (CMS) a written application for extension of the 1115 Demonstration waiver for the Health Care Independence Program and to hold public hearings to receive comments on the extension application to the Demonstration Waiver. The State anticipates submitting an application to amend the Demonstration in Spring of 2016 to replace the Health Care Independence Program implemented under the current 1115 waiver authority with a program reflecting the features now under consideration by the Governor, the Arkansas Legislative Task Force on Healthcare Reform, and the Arkansas Legislature.
Get more information regarding the public notice and the proposed extension application to 1115 Waiver.
REMINDER: Bill ICD-10 Diagnosis Codes Without Decimals
Added 10/9/15 – 4:30 p.m.
Please remember to omit decimals in all ICD-9 and ICD-10 codes when submitting claims for payment. For example, diagnosis code E119.5 should be entered as E1195. This is not a new requirement. Decimals have not been allowed in ICD-9 codes and they are not allowed in ICD-10 codes.
Billing ICD-10 codes with PES
If you currently use Provider Electronic Solutions (PES) software to bill claims, you MUST upgrade to version 2.23 or you will be unable to submit claims with ICD-10 codes. You must upgrade your software in sequential order; each lower version must be upgraded before you can upgrade to the next version. If you are currently using version 2.20, you MUST upgrade to 2.21, then 2.22, then 2.23, which is the latest version of PES. Claims submitted without ICD-10 codes for dates of service or dates of discharge on or after 10/1/15 will NOT be paid. Upgrade to PES 2.23 today.
Claims Submitted without ICD-10 Codes for Dates of Service on or After 10/1/15 Will NOT Be Paid
All claims submitted to Arkansas Medicaid for Dates of Service on and after 10/1/15 must bill using ICD-10 codes. Claims that do not bill ICD-10 codes will deny and you will not be paid by Arkansas Medicaid. This is a Federal mandate. Feel free to contact Arkansas Medicaid for assistance. With more than 38,000 providers, we expect a high volume of inquiries and possible delays in responses. We appreciate your patience.
Please visit the ICD-10 website for more information. (HTML, new window)
Request for Information on Managed Care for Medicaid Special Needs Populations: DHS thanks all those who participated in the RFI process
The Arkansas Department of Human Services has issued a Request for Information (RFI) on Managed Care for Special Needs Populations, with a deadline for responses from potential vendors of June 15, 2015. This RFI is intended to explore opportunities for implementing managed care for Medicaid-eligible clients receiving behavioral health services, developmental disabilities services, and care for the aged, frail, and physically disabled. The materials and information submitted by managed care organizations in response to this RFI will be reviewed to inform the path forward for improving care for many of Arkansas’ highest need Medicaid clients.
The Request for Information period is now closed, and DHS would like to thank those organizations who submitted responses to the RFI, as well as all stakeholders and members of the public who submitted questions, comments and suggestions. DHS is undertaking a process of review and consideration of all responses received, and will post additional information on the next steps at the appropriate time. Responses to the RFI received by DHS have been posted. Get more information about the RFI.
Insurance Cards for Private Option Enrollees
Private Option enrollees will not receive Medicaid ID cards but will receive insurance cards from their private health plan issuers. Private Option enrollees will use their private insurance cards to access medical services. Medicaid will provide limited supplemental services for Private Option enrollees, including Early and Periodic Screening, Diagnosis, & Treatment (EPSDT) for 19 and 20 year olds and non-emergency transportation. These services can be accessed using the Medicaid ID number that was sent to the Private Option enrollee in the plan enrollment notice. The Medicaid ID number can be used for retroactive coverage and interim coverage from the eligibility approval date until the date that the qualified health plan takes effect.
Newly eligible adults that are exempt from participation in the Private Option (e.g. medically frail individuals) will be enrolled in fee-for-service Medicaid and will receive a Medicaid ID card.
Frequently Asked Questions about the Arkansas Health Care Independence Program
View or print frequently asked questions about the Arkansas Health
Care Independence Program. (PDF, new window)
Arkansas Medicaid Reports and Data for Public Access
Arkansas Health Care Payment Improvement Initiative
Get more information about the Arkansas Health Care Payment Improvement
Initiative. (HTML, new window)
EHR Incentive Payment Program
You may be eligible for incentive payments or reimbursements of up to $63,750 from Medicaid to help offset the cost associated with implementing an electronic health record system. To find out if you are eligible, use the following links: