Timely Information from Arkansas Medicaid
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ICD-10 Issue: EOB 153 – RESOLVED
Added 11/23/15 – 3:00 p.m.
The ICD-10 error that caused claims with dates of service on and after 10/1/15 to deny for EOB 153 has been resolved. Suspended claims are being recycled. Providers who had claims deny for EOB 153 can rebill the claims. We appreciate your patience.
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.
Alternative Care Providers Must Bill Z736 for ICD-10 Claims
Added 10/6/15 – 10:00 a.m.
Alternative care providers billing Z73.6 for the ICD-10 claim form (time sheets) must NOT include the period (.) when entering the claim. Enter Z736 on the ICD-10 claim form (time sheets) - with NO period (.) - or the claim will deny.
High Call Volume Related to ICD-10 Issues
Added 10/1/15 – 8:00 a.m.
We are currently experiencing high call volume related to ICD-10 billing 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.
Save Your Coder’s Sanity! Get Trending ICD-10 Answers Here
Updated 10/1/15 – 8:00 a.m.
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.
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)
Changes to ARKids-B Coverage Beginning August 1, 2015
Effective 8/1/15: ARKids-B beneficiaries are no longer eligible for the VFC program. However, providers are still able to obtain vaccines to administer to ARKids-B beneficiaries by contacting Bill Ledford with ADH at 501-661-2723 or firstname.lastname@example.org and indicating the need to order “ARKids-B SCHIP vaccines”. For dates of service on or after 8/1/15, modifier “SL” will be required when billing for the administration of SCHIP vaccines to ARKids-B beneficiaries.
Effective for dates of service on or after 8/1/15, the services of orthodontia, occupational therapy, physical therapy, and inpatient psychiatric hospital and psychiatric residential treatment facility services will be covered services for ARKids-B beneficiaries. More information regarding these services is available in the ARKids provider manual. (Word, new window)
VFC and ARKids-B SCHIP vaccines
Separate storage for VFC and ARKids-B SCHIP vaccines can be accomplished through clearly labeling the VFC and ARKids-B SCHIP vaccine vials and placing each on separate shelves of the storage unit. STORAGE in SEPARATE STORAGE UNITS is NOT REQUIRED.
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.
Proposed Amendment to Health Care Independence (aka Private Option) 1115 waiver
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 request to amend the Health Care Independence 1115 Demonstration waiver and to hold public hearings to receive comments on the amendments to the Demonstration.
Get more information regarding the public notice and the proposed amendment to 1115 Waiver special terms and conditions.
Post-Award Forum for Arkansas Health Care Independence (aka Private Option) Program
On Friday, June 13, the Arkansas Department of Human Services (DHS) held a Post-Award Forum to provide the public with an opportunity to offer comment on the progress of the Arkansas Health Care Independence Program (commonly known as the Private Option).
Read the comments and review the Post-Award Forum transcript.
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: