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Implementing a Change for the Better

New MMIS 101

The Arkansas Department of Human Services (DHS) is pleased to announce the delivery of a new Arkansas Medicaid Management Information System (MMIS) in the last quarter of 2017. Arkansas Medicaid providers and beneficiaries rely on a MMIS for provider enrollment, beneficiary eligibility and claims processing. If you submit Arkansas Medicaid claims, they will be processed through this new system. The new MMIS will bring cutting-edge technology to DHS, Arkansas Medicaid providers and beneficiaries.

Check this page often for the latest alerts and important information regarding implementation and for opportunities to learn about the new MMIS. The more you know, the smoother your transition will be. The new MMIS and Healthcare Portal will offer many features such as personalization and @neTouch to make your workflow effective, efficient and accurate. The success of the new MMIS depends on your satisfaction as an Arkansas Medicaid provider.

Alerts

Sign Up to Receive MMIS eBlasts

Added 8/7/17
Receive the latest information regarding the new MMIS directly to your inbox! Sign up for AFMC’s eBlast messages today. (HTML, new window)

Added 6/22/17
A new issue of the ARMedicaid Insider has been released. View or print Volume 2, Issue 4 now. (PDF, new window)

Get ready for Go-live!
Updated 6/22/17
Early HealthCare Provider Portal registration will begin in September 2017. When registration becomes public, Arkansas Medicaid providers will be able to register for provider portal access and assign delegate access. All provider portal functionality will be open after Go-live.

Registering for access and assigning delegates proper access are a provider’s first steps to begin using the new healthcare provider portal. We encourage providers to attend training sessions in preparation of the portal registration opening. Understanding the portal registration process and delegate access options will be covered in the workshops and will help ensure your success with the new provider portal.

If you have a billing company, they will need to enroll as a trading partner and can also register to use the new portal. You will need to contact your billing company using this trading partner letter to notify them of the upcoming change.

Schedule your training today and get ready to register!

Change to Medicare Cards Coming Soon
Added 4/12/17
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.

FAQ

When will the new MMIS become available?

The new MMIS will be available in the last quarter of 2017.

How can I learn more about the new MMIS and how to use it?

We will keep you informed of the progress of the development and delivery of the new MMIS, so we encourage you to check this page often to stay up-to-date!

What do I need to do now?

Be on the lookout! Watch for ARMedicaid Insider issues, your first source for project updates, training in your area and web portal registration.

How can I alert my trading partners about the new MMIS?

If you currently rely on a vendor, clearing house, or billing company ( i.e., a trading partner) to submit claims or any other electronic transaction to Arkansas Medicaid, you must contact them immediately to notify them of changes that must be made regarding the submission process for the new system. A letter addressed directly to trading partners outlines the actions that need to be taken prior to Go-live in order to be ready to submit transactions on day one. Download the trading partner letter now. (PDF, new window)

How can I find out what is next?

Check your mail! Our mailers will include details on the new Healthcare Portal and how to receive training for your specific needs in 2017. The mailings and this web page should be your first resources for questions and information.

What’s in this implementation for me?

The new MMIS will provide Arkansas Medicaid providers with a heightened level of service and interactivity through the new Healthcare Portal including:

  • New online provider enrollment application including electronic documentation submission
  • New claim submission with real-time responses
  • New electronic Prior Authorization (PA) requests and status checks
  • New electronic uploads of attachments to claims and PAs
  • View and print Remittance Advices (RAs)
  • Online beneficiary eligibility verification

Can we use the same log in and password we have now?

Yes, if your password meets the complexity requirements (at least one upper case letter, one lower case letter and one numerical digit), you may use it on the new provider portal. Each user must register for access to the provider portal. Passwords expire after 60 days.

If I forget my security question, who should I call?

You will need to contact the EDI Support Center at 800-457-4454.

Will delegates be able to electronically assign Primary Care Physicians (PCPs) for beneficiaries?

No, providers and/or delegates cannot assign PCPs. A PCP can be assigned by:

  • Calling the ConnectCare Help Line at 1-800-275-1131
  • Completing the PCP choice on a “Primary Care Physician Selection and Change” form (DMS 2609 or DCO-2609.)
  • Calling the Voice Response System 1-800-805-1512.

Will my remittance advice (RA) statements look the same?

The format for the RA will stay the same, however, more detailed information will be included.

What kind of file is the Remittance Advice on the claim search?

The RA is in portable document format (.PDF).

Can I check a prior eligibility date?

Yes, you can check previous dates back to one year. You cannot check for future eligibility dates.

Will Third-Party Liability (TPL) add the other health insurance (OHI) to the eligibility strip once entered on a keyed claim? Alternatively, do we still need to call TPL?

Yes. The TPL department with verify the other health insurance that was entered on a claim. Once verified, this information will be available on the Eligibility Search page under the Other Insurance hyperlink. It will no longer be necessary to call the TPL department.

When checking eligibility for today, will the results show that the member is inactive, and will it give the term date?

The portal will show the effective date and end date if the coverage has termed. If the coverage is current, it will supply them with the effective date. However, it will not list the end date for a current plan in the Healthcare Portal.

Will eligibility treatment history show the last well child exam/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) or is it under eligibility verification like the old system?

This information will be visible on the Eligibility Verification.

Where can I find specific benefits for a patient and their benefit limit?

In order to search for benefit limits, click on Eligibility Verification under the Eligibility tab and fill out the service type or procedure code section to get results on a beneficiary’s benefit limits. The Treatment History link will only give information on the services that were performed by your provider.

If we are filing a batch of claims on the portal, do we have to switch providers to match who we are filing the claim under?

You will need to contact the EDI Support Center at 1-800-457-4454 for instructions on this process.

Is there somewhere on the portal to check how many of the 12 visits a patient has completed for Rehabilitative Services for Persons with Mental Illness (RSPMI)?

Yes. If the provider searches under Treatment History, information on the services they provided for that beneficiary is given. If they want to know how many visits are used, they will need to search under the Eligibility Verification tab and enter the service type code or procedure code. The portal will give information on how many visits are used. However, the Eligibility Verification tab will not tell which provider was paid.

Will the Provider Search option show the physician’s provider number?

No. The Provider Search tab will give you the name and address of the provider. In order to obtain more information, you will need to contact the provider.

Does the provider portal alert me when a procedure requires prior authorization?

Providers will have to refer to the provider manual to determine if a code requires a prior authorization. The portal does not provide this information.

On a prior authorization for sedation, can Dental providers enter the day before on the “from” date?

Yes, the provider can request dates in the past.

Will the diagnosis dropdown menu prepopulate the full six-digit ICD-10 code?

As you type the diagnosis code, the portal will begin to prepopulate the diagnosis code allowing you to choose the desired code.

Where do I upload batch files created in facility-specific billing software?

Providers will need to contact the EDI Support Center for information concerning uploading batch files. Contact EDI at 1-800-457-4454.

How does file exchange work for Dental providers?

File exchange works the same for all provider types. File exchange allows download of letters/reports (if applicable) that were generated for the provider.

Where would I locate retraction letters or a non-emergency recoupment list?

The process of locating retraction letters and receiving non-emergency recoupment lists will not change with the new portal.

Will the $250,000.00 billed-threshold amount increase?

The maximum amount billed will increase to $9,999,999.99 per line.

When voiding a claim through the portal, can I resubmit a new claim right away, or do I have to wait until the voided claim processes on the upcoming remit to submit the new claim?

Yes, you should be able to void the claim and resubmit the new claim the same day.

Can I submit multiple dates of services on one claim submission if the CPT and diagnosis codes are the same for a beneficiary?

Yes. You can submit up to 200 lines for Dental and Professional and 999 lines for Institutional.

Will the new portal allow me to file two ambulance claims for the same date of service without denying one as a duplicate?

The process should be the same. However, you will be able to use the attachment option to submit the additional information required for review.

Can I copy a claim and submit it under a different provider for a multi-specialty clinic where the patient received services from a different provider group within the same clinic?

No. You cannot copy a claim from one provider to another.

Will the secure correspondence double as the appeal?

No. Work processes will not change. Providers will need to continue their current appeal process until otherwise noted.

Calendar

August 2017

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Testing

DXC Technology is considering forming a small group of partners willing to test the new system with us. If you are interested in participating, please reach out to us at arxixnewsystem@hpe.com.

Training

The new HealthCare Portal will benefit providers and beneficiaries alike offering a variety of functions unavailable on the current website. Don’t miss your opportunity to receive training on this cutting-edge technology. Check back soon for additional training opportunities.

Materials from Previous Workshops

Training Materials File Name File Size
Eligibility Verification MMIS_JobAid_Eligibility.pdf 1.7MB
MAPIR MMIS_JobAid_MAPIR.pdf 1.2MB
Prior Authorization MMIS_JobAid_PriorAuthorization.pdf 2MB
Registering on the Provider Portal MMIS_JobAid_ProvPortalReg.pdf 6.6MB
Registering on the Provider Portal – Delegates MMIS_JobAid_DelegatePortalReg.pdf 4.4MB
Registering on the Provider Portal – Trading Partners MMIS_JobAid_TradingPartnerPortalReg.pdf 2.1MB
Trading Partner ID Enrollment MMIS_JobAid_TrdngPrtnrIDEnroll.pdf 2.3MB
Search Payment History MMIS_JobAid_SearchPaymentHistory.pdf 946k
Submitting and Reviewing a Claim MMIS_JobAid_SubmittingReviewingClaim.pdf 3.4MB
Treatment History MMIS_JobAid_TreatmentHistory.pdf 1.5MB
Updating PCP Caseload MMIS_JobAid_UpdatingPCPCaseload.pdf 1.4MB
Uploading Documents MMIS_JobAid_UploadingDocuments.pdf 1.1MB
Using the new Medicaid Provider Portal PortalTraining.pdf 15MB

Webinar Dates

If you were not able to get away for a workshop, webinars are coming to teach you how to register for the new HealthCare Portal and how to submit claims. Links to available webinars will be posted in early September for viewing at your convenience.

Audience Content
All providers Portal Registration
Providers Billing with a Professional Claim Form Submitting and Reviewing Professional Claim Form
Providers Billing with an Institutional Claim Form Submitting and Reviewing Institutional Claim Form
Nursing Homes Census Forms
Dental Providers Submitting and Reviewing Dental Claim Form

Go to Arkansas Medicaid         dxc.technology

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