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What's new for Arkansas Medicaid providers

What's New for Arkansas Medicaid Providers

Content updated April 18, 2014

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Page Contents

CMS-1500 Claim Rejections Due to Numeric Entries in Field 24E
Hospitalists Now Eligible for EHR Incentive Payments
Handout Regarding CMS-1500 Version 02/12
New ADA J430 Dental Claim Form
Provider Enrollment Fees and Re-enrollment Guidelines
CMS-1500 Professional Claim Form
Patient-Centered Medical Home Enrollment
PCP Not Required for Newly Eligible Population
Provider Portal Password Self-Help Guidelines
Attestation for 2014 PCP Supplemental Payments
Insurance Cards for Private Option Enrollees
Monthly System Maintenance
Billing Bulletins
PES Trouble-Shooting Notes
New Provider Manual Updates
New RA Messages

CMS-1500 Claim Rejections Due to Numeric Entries in Field 24E

Added 4/10/14
Field 24E, Diagnosis Pointer, of the CMS-1500 claim form previously required numeric indicators that corresponded to a diagnosis code in Field 21.

CMS-1500 version 02/12 requires an alphabetic entry in this field. The diagnosis code reference letter pointer should be A-L, or multiple letters as applicable. For more information about how you should complete Field 24E, please refer to your provider billing manual, "Completion of the CMS-1500 Claim Form."

Hospitalists Now Eligible for EHR Incentive Payments

Added 4/4/14
As of April 1, 2014, with the implementation of MAPIR 5.3, a hospital-based physician (hospitalist) is eligible to apply for an EHR incentive payment. Providers are considered hospital-based if they provide 90% or more of their covered professional services in either a hospital inpatient (Place of Service 21) or emergency department (Place of Service 23) setting. Applying as a hospital-based physician means you are using your own certified EHR instead of the hospital’s.

All applicants are required to upload a signed contract, Letter of Intent to Purchase, or Proof of Purchase for the selected EHR to their MAPIR application; a hospitalist must also upload their contract/agreement with the hospital or a hospital administrator’s letter stating their status as a hospitalist.

If you have questions, please contact the AIPT at aipt@hp.com.

Handout Regarding CMS-1500 Version 02/12

Added 3/31/14
Arkansas Medicaid has replaced the National Uniform Claim Committee (NUCC) CMS-1500 form with version 02/12. View or print a provider relations handout regarding changes to the form for more information. (Word, new window)   View or print a sample CMS-1500 form. (PDF, new window)

New ADA J430 Dental Claim Form

Added 3/21/14
Arkansas Medicaid will implement the new ADA J430 claim form on 5/1/14. Paper claims received on or after 5/1/14 must be submitted using the new version. View or print a Sample ADA J430 form. (PDF, new window)

Provider Enrollment Fees and Re-enrollment Guidelines

Added 3/14/14
Effective July 1, 2013 the Arkansas Medicaid program adopted new enrollment fee and re-enrollment requirements that were mandated as part of the Affordable Care Act (ACA). As a result of these new guidelines, certain provider types are subject to a fee payable every five (5) years. In addition, all providers regardless of provider type are required to re-enroll every five (5) years.

The new enrollment process is set to begin April 1, 2014. Providers will receive a ninety (90) day notice that they must comply with the new enrollment guidelines. Providers will also receive notices sixty (60) and thirty (30) days prior to their enrollment deadline.

If the provider has paid the application fee to Medicare, or if the provider is enrolled in another State's Medicaid Program and has paid the fee to that State's Medicaid Agency, then the provider will not be required to pay the enrollment application fee to Arkansas Medicaid. View or print the listing of providers required to pay the fee. (PDF, new window)

For questions, please contact the Provider Enrollment Unit at 501-376-2211 or 1-800-457-4454 extension 300, option 3.

CMS-1500 Professional Claim Form

Added 3/14/14
Arkansas Medicaid will implement version 02/12 of the CMS-1500 claim form on 4/1/2014. Paper claims received on or after 4/1/2014 must be submitted using the new version.

Patient-Centered Medical Home Enrollment

Added 1/24/14
Patient Center Medical Home (PCMH) enrollment is now open through May 15, 2014.

Practices that enroll during this enrollment period will participate in PCMH program from July 1, 2014 through December 31, 2014.

To be eligible to enroll in the PCMH Program:

  1. The practice must be a participating practice as defined in PCMH manual Section 200.000 (Word, new window).
  2. The practice must include PCPs enrolled in the ConnectCare Primary Care Case Management (PCCM) Program.
  3. The practice may not participate in the PCCM shared savings pilot established under Act 1453 of 2013.
  4. The practice must have at least 300 attributed beneficiaries at the time of enrollment.

Enrollment in the PCMH program is voluntary and practices must re-enroll annually. To enroll, practices must access the provider portal at www.paymentinitiative.org (HTML, new window) and submit a complete and accurate Arkansas Medicaid Patient-Centered Medical Home Practice Participation Agreement (DMS-844 Word, new window).

PCP Not Required for Newly Eligible Population

Added 1/23/14
Effective January 1, 2014, a Premium Assistance enrollee (aid category 06) in the Newly Eligible Population is not required to have a PCP assigned in order to receive services. To prevent claim denials, providers should hold claims with dates of service from 1/1/14 to 1/24/14 and submit them after 1/24/14. Please contact the Provider Assistance Center with any questions or for further information.

Provider Portal Password Self-Help Guidelines

Updated 1/21/14
Beginning February 1, 2014, Provider Portal users will be locked out after six failed login attempts within an hour. Providers must use the provider portal's self-help processes to resolve all password issues. This change will improve security under HIPAA requirements. For more information, view or print the password self-help guidelines. (PDF, new window)

Attestation for 2014 PCP Supplemental Payments

Added 1/17/14
To receive supplemental PCP payments in 2014, providers must re-confirm their eligibility for supplemental payments by completing the self-attestation process. The self-attestation process is available online through the Provider Portal or via paper form.

  1. Attest online using the provider portal.

  2. To request a paper attestation form, contact the Arkansas Medicaid Provider Enrollment Unit at (501) 376-2211 (local or out of state) or (800) 457-4454 (Arkansas); when prompted, select 0 for "Other Inquiries", then option 3 for "Provider Enrollment".

    The paper form can be mailed or faxed to the Arkansas Medicaid Provider Enrollment Unit:
    Medicaid Provider Enrollment Unit
    HP Enterprise Services
    P.O. Box 8105
    Little Rock, AR 72203-8105
    Fax: (501) 374-0549

Insurance Cards for Private Option Enrollees

Added 1/3/14
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.

Monthly System Maintenance

System maintenance will be performed from 10:00 p.m. to 2:00 a.m. on the first and third Saturday of each month. During the maintenance period, you will not be able to verify eligibility interactively; however, you will still be able to enter claims and check eligibility through Arkansas Medicaid's website. Batch transactions received during this period will be held in queue and will be processed as soon as maintenance is complete. Pharmacy claims will not be affected.

Billing Bulletins

For the latest billing news, see Billing Bulletins.

PES Trouble-Shooting Notes

If you're having trouble using Provider Electronic Solutions software, please see PES Trouble-Shooting Notes.

New Provider Manual Updates

Added 4/18/14
Arkansas Medicaid released a Dental provider manual update. View the transmittal letter for provider manual update DENTAL-7-13. (Word, new window)  View changes to the Dental provider manual. (Word, new window)

Arkansas Medicaid released a Section V all provider manuals update. View the transmittal letter for all provider manuals update SecV-1-13. (Word, new window)  View changes to Section V of all provider manuals. (Word, new window)  View or print a Sample ADA J430 form. (PDF, new window)

Added 4/4/14
Arkansas Medicaid released a Hyperalimentation provider manual update. View the transmittal letter for provider manual update HYPER-2-14. (Word, new window)  View changes to the Hyperalimentation provider manual. (Word, new window)

Arkansas Medicaid released a Prosthetics provider manual update. View the transmittal letter for provider manual update PROSTHET-2-14. (Word, new window)  View changes to the Prosthetics provider manual. (Word, new window)

Added 4/3/14
Arkansas Medicaid released a Rehabilitative Services for Persons with Mental Illness (RSPMI) provider manual update. View the transmittal letter for provider manual update RSPMI-3-14. (Word, new window)  View changes to the RSPMI provider manual. (Word, new window)

Added 4/1/14
Arkansas Medicaid released a Hospital provider manual update. View the transmittal letter for provider manual update HOSPITAL-1-13. (Word, new window)  View changes to the Hospital provider manual (1-13). (Word, new window)

Added 3/28/14
Arkansas Medicaid released a Podiatrist provider manual update. View the transmittal letter for provider manual update PODIATR-1-14. (Word, new window)  View changes to the Podiatrist provider manual. (Word, new window)

Arkansas Medicaid released a Section I all provider manuals update. View the transmittal letter for provider manual update SecI-5-13. (Word, new window)  View changes to Section I of all provider manuals. (Word, new window)

Arkansas Medicaid released a Section V all provider manuals update. View the transmittal letter for provider manual update SecV-2-14. (Word, new window)  View changes to Section V of all provider manuals. (Word, new window)

Added 3/21/14
Arkansas Medicaid released a Pharmacy provider manual update. View the transmittal letter for provider manual update PHARMACY-1-14. (Word, new window)  View changes to the Pharmacy provider manual. (Word, new window)

Arkansas Medicaid released a Physician provider manual update. View the transmittal letter for provider manual update PHYSICN-5-13. (Word, new window)  View changes to the Physician provider manual. (Word, new window)

New RA Messages

Added 4/18/14
Arkansas Medicaid released an RA message to All Providers. View the RA message regarding 2014 Certified EHR. (Word, new window)

Arkansas Medicaid released an RA message to All Providers. View the RA message regarding CPT Procedure Code 92558. (Word, new window)

Added 4/11/14
Arkansas Medicaid released an RA message to All Providers. View the RA message regarding CMS-1500 Professional Claim Form. (Word, new window)

Arkansas Medicaid released an RA message to All Providers. View the RA message regarding ICD-10 Implementation. (Word, new window)

Added 3/28/14
Arkansas Medicaid released an RA message to Patient-Centered Medical Home Providers. View the RA message regarding Extension Of High Priority Beneficiary Selection. (Word, new window)

Added 3/21/14
Arkansas Medicaid released an RA message to Dental Providers. View the RA message regarding New ADA J430 Dental Claim Form. (Word, new window)