Timely Information from Arkansas Medicaid
All systems are currently online.
Professional Claims Payment for Admitted Inmate Population
Hospital, Physician, Oral Surgeon, Nurse Practitioner, Certified Nurse-Midwife, Podiatrist and AHEC Physician Providers:
Effective 4/21/17, professional claims submitted electronically for physican fees with POS 21 for Aid Category 06 with OPI Indicator I (Inmate) can be submitted and paid electronically.
Change to Medicare Cards Coming Soon
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandates the removal of the SSN-based HICN from Medicare cards to address the current risk of beneficiary medical identity theft. Per the legislative requirement, CMS must mail out all Medicare cards with the new Medicare Beneficiary Identifier (MBI) by April 2019.
Will your practice management system need to make any changes to use the new MBI? If so, you’ll need to make those changes and test them from October 2017 until April 2018.
Get additional information about the new Medicare cards. (HTML, new window)
Stay tuned for additional information to learn about system updates and requirements, along with dates to remember.
Hewlett Packard Enterprise Services now DXC Technology
On April 1, 2017, Hewlett Packard Enterprise Services, the fiscal agent for Arkansas Medicaid, merged with CSC to form DXC Technology. Arkansas Medicaid providers will begin seeing the DXC Technology logo and name on correspondence. Emails from the fiscal agent will be from a dxc.com email address rather than an hpe.com address. Providers will also hear the new name when contacting a call center. DXC Technology will continue to provide the same level of service to the state of Arkansas and its Medicaid providers.
Your Information Hub for the New MMIS
The Arkansas Department of Human Services is pleased to announce the delivery of a new Arkansas Medicaid Management Information System (MMIS) in mid-2017. The new MMIS will bring cutting edge technology to DHS, Arkansas Medicaid providers and beneficiaries.
The Front Line webpage is designed to keep you informed and includes
- Training opportunities
- Upcoming implementation-related events
Learn more and add Front Line to your favorites now! (HTML, new window)
Arkansas Works – Changes to the Medicaid Program
Although the Health Care Independence Program (often referred to as the Private Option) is ending, Arkansas has received approval for “Arkansas Works.” Arkansas Works will provide the same type of healthcare coverage and will cover the same benefit categories.
Arkansas Works begins January 1st, 2017, and includes changes that are important for providers to know. The majority of Medicaid beneficiaries in Arkansas Works will not see any change to their coverage for 2017. Below are high-level changes that might drive questions by patients to their providers:
- Arkansas Works will continue to use premium assistance to purchase Qualified Health Plans (QHP) offered through the individual market in the Marketplace for those eligible for expanded coverage.
- Beneficiaries who have access to cost-effective small group employer sponsored insurance (ESI) coverage will be required to enroll with their employers’ ESI if their small group employer has already enrolled with Arkansas Works. Arkansas Medicaid will ensure that the ESI plan complies with federal requirements for cost effectiveness and benefits and will wrap cost sharing to Medicaid allowable limits.
- In 2017, a $13 monthly premium will be charged to the enrollees who have household incomes above 100% of the Federal Poverty Level (FPL) and are also in a QHP/ESI. In subsequent years, enrollees will be required to pay a monthly premium of up to 2% of their household income.
- If an enrollee does not pay their premium, they will not lose eligibility but will accrue a debt to the state.
- The premium payment will be paid to the QHP carrier or to their employer if they are in an ESI.
- Beneficiaries who are determined to be below 100% FPL will not have a premium obligation.
Timely Filing Issues
In an effort to resolve claims denied for eligibility beginning with dates of service on 10/1/2013, Arkansas Medicaid has made modifications to bypass the timely filing edits. Claims are to be submitted electronically. Providers must verify that an eligibility segment for the dates of service in question is available on file and verify that a PCP, if required, is on file before the claim is submitted. Providers will have an open window between October 17, 2016 and April 15, 2017 to submit claims. A listing of permissible reasons for qualifying claims may be obtained on this FAQ document (PDF, new window) along with other pertinent information.
CLAIMS FILED BY PROVIDERS THAT DO NOT QUALIFY UNDER THE IDENTIFIED LISTING WILL BE REVIEWED AND RECOUPED.
Arkansas Medicaid and the Arkansas Foundation for Medical Care (AFMC) now offer a timely filing webinar. Go to the AFMC website to view the webinar. (HTML, new window)
Claims Over 365 Days Old
For those providers who have submitted timely filing claims, these claims will be processed no later than Friday, November 4, 2016.
Denial of ARKids First-B for Age Ineligibility
If an eligibility strip showed an ARKids First-B beneficiary as eligible at date of service but the claim was denied due to age ineligibility, please resubmit the claim. If the claim is beyond 365 days, resubmit following the timely filing instructions on the Medicaid website.
RSPMI CLAIMS WITH EOB 952 (PCP REQUIRED)
The ICD-10 error that caused RSPMI claims for beneficiaries over age 21 with dates of service on and after 10/1/15 to deny for ERROR CODE 107/EOB 952 (PCP REQUIRED) has been resolved. Suspended claims are being recycled. Providers who had claims deny for EOB 952 can rebill the claims. We appreciate your patience.
Update on the Removal of the 24-day Cap
DMS Program Planning and Development has issued a provider memo to all hospital providers. View or print the memorandum regarding Removal of the 24-day Cap. (Word, 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: