Yes. Providers II-3 200.120 Arkansas Medicaid Participation Requirements for Living Choices Assisted Living Agencies II-5 200.130 Arkansas Medicaid Participation Requirements for Living Choices Assisted Living Pharmacist Consultants II-8 200.200 Provider Staffing Requirements for … We serve participants in the Arkansas Medicaid The Arkansas Division of Medical Services (DMS), part of the Department of Human Services (DHS), has made great strides recently to strengthen the Medicaid provider enrollment process. enrollment in the Medicaid program. You can only report your NPI and associate your Taxonomy codes using this tool. Arkansas Medicaid will only accept the National Provider Identifier (NPI) number anywhere a provider number is required on electronic transactions. Provider Enrollment Revalidation Webinar – Nov. 8, 2018. §455, Subpart B: Disclosure of Information by Providers and Fiscal Agents] DMS-2608 (Rev. As required by HIPAA, the Secretary of Health and Human Services is adopting standards for the following administrative and financial health care transactions: Implementation Guides are available from the CMS website or from Washington Publishing Company. If the Medicaid Provider numbers were previously linked, registering the NPIs will not affect those linkages. In order to get an NPI, a provider must be a health care provider as defined under HIPAA. To enroll as an Arkansas Medicaid provider, the easiest way is to apply online. Use this guide to find out if you qualify and how to apply. Using Medicaid with Medicare or other Medical Insurance, ARKids – Additional Resources That Can Help Your Family, Important Phone Numbers for ARKids First Program, PASSE – Care Coordination and Person Centered Service Plan, National Provider Identifier (NPI) Information, Practitioner Identification Number (PIN) Frequently Asked Questions, What’s New for Arkansas Medicaid Providers, Arkansas Juvenile Assessment & Treatment Center (AJATC), Office of Legislative & Intergovernmental Affairs, Office of Communications & Community Engagement, Go to the NPPES website to view or use the NPI Registry, Go to the NPPES website to download the data file. Proceed by following the steps to report your NPI. The reporting crosswalk tool will step you though entering the necessary data so Arkansas Medicaid can recognize your new ID number. In order to report your NPI, log on the Health Care Provider Portal by entering your user ID and password. Be sure to get your NPI and report it to Arkansas Medicaid using the Web-based NPI reporting crosswalk tool. Arkansas Medicaid only accepts the National Provider Identifier (NPI) number anywhere a provider number is required on electronic transactions. You do not need to use both. If you submit claims without having reported your NPI, your claims will be denied with the error code “provider not on file.” Gainwell Technologies developed a reporting crosswalk tool to help providers communicate their National Provider Identifiers to Arkansas Medicaid. Transportation is provided only to and from Medicaid-covered services. Use only one method, either the paper form or the Web-based NPI reporting crosswalk tool. DHS County Offices (HTML, new window) Healthcare Quality and Payment Policy Advisory Committee (HTML, new window) Report Problems With This Website. Provider Enrollment and Certification; Arkansas Arkansas State Name. Paper claims submitted with only an NPI will be returned for correction. Provider Information. What’s new for Arkansas Medicaid providers. Go to the NPPES website to view or use the NPI Registry.Go to the NPPES website to download the data file.More information about NPPES Data Dissemination. Contact us at 501-992-1710 and our friendly staff will help guide you through the process. State/ Territory State/Territory Provider Enrollment Web Site Link Contact Phone Number(s) Email AK Alaska Provider Enrollment AL. Registering your NPI will only create a one-to-one match between the Arkansas Medicaid Provider ID and the NPI. Using EDI does not determine if the provider is providing health care services or not. Provider Portal Functionality - Draft Claims. In most cases no. In order to link your NPI number with your Arkansas Medicaid provider ID, you must register your NPI with Arkansas Medicaid. Arkansas Medicaid Provider Portal Application Required Documents October 2018 . Select option 0 for “Other inquiries” and then option 3 for “Provider Enrollment” when prompted or option 2 for “Provider Assistance Center” when prompted. The rendering NPI will be required on electronic claims transactions. If you have questions, contact Provider Enrollment toll-free at (800) 457-4454 or local at (501) 376-2211. 2 Table of Contents ... tables to identify your Enrollment Type options, Provider Type Code, Provider Category and all of the documents you are required to submit with your application. National Plan and Provider Enumeration System (NPPES), https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/efi, https://www.cms.gov/regulations-and-guidance/administrative-simplification/nationalprovidentstand, Go to the NPPES website to view or use the Registry. Organization providers may have the option to obtain more than one NPI. You may fax the NPI Reporting Form to (501) 374-0746 ormail it toMedicaid Provider Enrollment Unit – NPIGainwell TechnologiesP.O. Select option 0 for “Other inquiries” and then option 3 for “Provider Enrollment” when prompted. The NPI reporting crosswalk tool will only allow a user to enter 1 taxonomy code. (HTML, new window) Return to list Medicaid is a state and federal program that provides health insurance to people with low incomes. Arkansas Total Care is a Provider-Led Arkansas Shared Savings Entity (PASSE), a partnership between an insur ance payer, a provider group, and a specialty services provider. 1-1-10) An individual or business that is not a health care provider and does not meet the definition of a health care provider according to the NPI Final Rule. In an effort to work collaboratively with all our provider partners and the Arkansas Department of Health and Human Services, Arkansas Total Care has decided to delay these fee schedule changes until after April 1, 2021. Added 4/8/21 From Available Tools select “Report NPI.”. View Section 211.200 – Staff Requirements in the OBHS provider manual.. How can I request a Practitioner Identification Number (PIN)? Using Medicaid with Medicare or other Medical Insurance, ARKids – Additional Resources That Can Help Your Family, Important Phone Numbers for ARKids First Program, PASSE – Care Coordination and Person Centered Service Plan, National Provider Identifier (NPI) Information, Practitioner Identification Number (PIN) Frequently Asked Questions, What’s New for Arkansas Medicaid Providers, Arkansas Juvenile Assessment & Treatment Center (AJATC), Office of Legislative & Intergovernmental Affairs, Office of Communications & Community Engagement, Become a Community & Employment Support (CES) Waiver Service Provider, Child Care Professional Development Registry, Community Services Licensure And Certification, resume work on an existing provider enrollment application, check the status of the application you submitted, pay the Medicaid provider enrollment application fee. Click the Enrollment Application link. No. Atypical providers must continue to use their Arkansas Medicaid provider ID. Provider Enrollment … When the NPI Reporting Form is received, Gainwell Technologies will enter the information into the system from the paper document. Guide to the Arkansas Medicaid Program. We’re a Provider-Led Arkansas Shared Savings Entity (PASSE). There is no cost to apply and providers may apply for an NPI in one of three ways: Providers must furnish any updates to the NPPES within 30 days of the change if any of the required data submitted on the application changes. Select option 0 for “Other inquiries” and then option 3 for “Provider Enrollment” when prompted. If providers have questions or need assistance with the online application, please contact the Arkansas Medicaid Provider Enrollment Office at (501) 376-2211 … The intent of the NPI is to eliminate the need for payers and providers to keep numerous identifiers and in turn simplify transaction processing between entities. DME Compensation Schedule (PDF) Provider Newsletter. If you submit claims on paper, use the CMS-1500, CMS-1450, or dental claim form. The NPI is a single identification number assigned to health care providers. Paper claims submitted with only an NPI will be returned for correction. The same NPI can be reported for different service locations; however, if the same NPI is reported, there must be a different taxonomy, zip code+4, or physical street address reported for the various locations. In doing so, they have created a more user-friendly process that should save time for doctors, hospitals and other Medicaid providers. If you have any questions or problems regarding your NPI, contact Provider Enrollment at (501) 376-2211 (local) or at (800) 457-4454 (toll free). New RA Messages. To change your demographic information, submit an address change form. What's New. Arkansas Medicaid-Related Links. To better serve the Kansas Medical Assistance Program (KMAP) providers during the COVID - 19 public health emergency, this page contains the latest information regarding the COVID - 19 changes being implemented by KMAP.. COVID - 19 Provider Information Personal Care Webinar Presentation. Affiliated provider listing available in the provider portal; Antigen testing Please note that your physical address could be used to help determine who you are when submitting claims electronically with your NPI, so make sure you verify the physical billing address we have on file for you. Additional information about the types of providers and subparts may be obtained from the CMS website or the NPPES website. The provider’s NPI does not change and remains with the provider regardless of job or location changes. You can log back into the NPI reporting crosswalk tool at any time to report the NPI for providers. Annual Billing Workshop Presentation. For billing related issues with your NPI, contact the Provider Assistance Center (PAC). Box 8105Little Rock, AR 72203-8105. No. Using the Web-based NPI reporting crosswalk tool is quicker and more efficient. Home Delivered meals. If you refer a patient to a physician who submits claims electronically, your NPI will be required to complete their claims. Arkansas Improvements to Medicaid Provider Enrollment Process. There is no charge to use the NPI Registry. Arkansas Medicaid requires all health care providers (individual, organization, and subparts of an organization) who provide health care services and submit electronic or paper claims to obtain an NPI. Those identifiers include the Arkansas Medicaid provider number otherwise known as the legacy provider identifier (LPI) and Medicare legacy provider identifier such as the unique physician/provider identification number (UPIN); Online Survey, Certification, and Reporting (OSCAR); physician/provider identification number (PIN); and National Supplier Clearinghouse (NSC). If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or toll free at (800) 457-4454. Learn more about PASSE. Arkansas Medicaid Contact Information. You cannot remove a rendering provider with the tool. If you have already reported your NPI number to Arkansas Medicaid, your NPI information has been successfully linked to your Arkansas Medicaid Provider number. Provider Enrollment. About Summit Community Care. Some examples would be the billing, performing, requesting, attending, referring and prescribing provider number as appropriate for the transaction submitted. Top 4 provider enrollment issues when applying on the portal. NPI numbers for referring physicians or prescribers are necessary for electronic billing. Providers applying to NPPES for an NPI are required to submit their Taxonomy codes. View Private Option/Arkansas Works quarterly and annual reports. Providers that are required to report their Taxonomy code in the NPI reporting crosswalk tool are also required to report their Taxonomy code on claims. Arkansas Medicaid covers 27 percent of the state’s population. Data and Reports for Public Access. Groups are allowed to obtain the NPI from their rendering providers and report it to Arkansas Medicaid on the rendering providers’ behalf. The NPPES also stores the information about enumerated providers. Provider Enrollment (800) 457-4454, in-state toll-free or (501) 376-2211 local and out-of-state Go to Provider Enrollment. Related Links ... A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Arkansas Medicaid will read only the NPI on claims unless the provider is atypical. Some examples would be the billing, performing, requesting, attending, referring and prescribing provider number as appropriate for the transaction submitted. The information you enter into the NPI Reporting Tool is updated in real-time for viewing data but in batch mode for claims processing. Home > Become a Provider > Become a Medicaid Provider. Yes. The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Arkansas for the 2021 plan year: A … Arkansas Medicaid only accepts the National Provider Identifier (NPI) number anywhere a provider number is required on electronic transactions. It will not affect individual-group provider relationships. The following resources will help you understand and deal with the NPI and its impact on Arkansas Medicaid. If you have already reported your NPI number to Arkansas Medicaid, your NPI information has been successfully linked to your Arkansas Medicaid Provider number. Yes. Yes, an atypical provider such as a non-emergency transportation provider may use electronic data interchange (EDI). Medicare NPI policy and recommendations are available on the CMS website at https://www.cms.gov/regulations-and-guidance/administrative-simplification/nationalprovidentstand. If providers have questions or need assistance with the online application, please contact the Arkansas Medicaid Provider Enrollment Office at (501) 376-2211 … In other words, rather than having a provider or group of providers submit a paper or Web NPI application, the EFIO obtains an NPI for them via the submission of an electronic file. Enter your information and when you reach the question, “Are you currently enrolled as a Provider?” click yes, and then enter therovider ID. The batch will be accepted, the individual claim with the missing NPI will not. New Provider Workshop Presentation. Tools and resources for provider … Electronic billing has virtually eliminated the need for paper claims. Yes. When prompted, select 0 for “Other Inquiries”, then option 3 for “Provider Enrollment”. When applying online, there is less possibility for making errors that would result in your application being denied and returned to you for correction. P.O. View or print the SecV-4-21 transmittal letter. A query-only database, known as the NPI Registry. Information about NPI Application and Enumeration is available from the NPPES website. Agenda. All providers, including relatives, are required to meet all ARChoices provider certification requirements, Arkansas Medicaid enrollment requirements and provide services according to the beneficiary’s PCSP and any established benefit limits for that specific service. If you have questions about reporting NPI information, please contact Provider Enrollment toll-free at (800) 457-4454 or local at (501) 376-2211. Under “Would you like to enroll as a Provider or a Trading Partner?” click the Provider link. Not all waiver providers are atypical providers. If a health care provider’s NPI is used in the case of fraud, a new NPI will be issued. (Word, new window) View or print changes to Form DMS-7708, Practitioner Identification Number Request Form. If a physician is deceased, and electronic claims or adjustments will be submitted on his behalf after the NPI compliance deadline, an NPI must be reported for the physician. Provider Enrollment Help and Information. Yes. The Final Rule for NPI requires a “covered entity” health care provider to get an NPI. Before any NPI is reported the header will be Blue (not reported), an unsuccessful entry will be Red (conflict), and a successfully reported NPI will have a Green (Active) header. Contact information is required only once for each time a user logs into the system to report NPIs. Personal Care Response System. Providers may have one or more Taxonomy codes associated to them. 7500 Security Boulevard, Baltimore, MD 21244. Some components or subparts of an organization may be eligible to obtain separate NPIs. An individual provider may report their NPI independently. Enrollment. To apply for an NPI through the Internet, go to the NPPES website. “Atypical” means non-traditional medical services. For Arkansas Medicaid, atypical providers include. Provider Enrollment can be reached toll-free at (800) 457-4454 or local at (501) 376-2211. The NPI Final Rule issued January 23, 2004, adopted the NPI as this standard. (Word, new window) Return to list. No. Gainwell Technologies will not offer a directory of NPIs; however, the National Provider Identifier (NPI) Registry is available now at the National Plan & Provider Enumeration System (NPPES) website. The NPI must also be used on electronic eligibility verification transactions. If a health care provider moves to a different geographical location, it will not affect the NPI. If the NPI reporting crosswalk tool identifies a rendering provider that is no longer in your group, contact Provider Enrollment to disassociate the rendering provider. Start a new online application. Groups are allowed to obtain NPIs from their rendering providers and report them to Arkansas Medicaid on the rendering providers’ behalf. Arkansas currently has the authority to rely upon provider screening that is performed by other State Medicaid Agencies (SMAs) and/or Medicare. Arkansas Medicaid. Provider Enrollment can be reached toll-free at (800) 457-4454 or local at (501) 376-2211. If a provider is required to report a Taxonomy code when using the Web-based NPI reporting crosswalk tool, only one Taxonomy can be chosen regardless of how many taxonomies were reported to NPPES. This white paper can be found on the WEDI website at http://www.wedi.org. If you submit paper claims, you must use your Arkansas Medicaid Provider ID. A link to the Registry has been added to the “Provider information” menu for quick access from the Arkansas Medicaid website. If you are required to have a National Provider Identifier (NPI), you must report it to Arkansas Medicaid once enrolled as an Arkansas Medicaid provider. National Plan & Provider Enumeration System (NPPES) health care provider data that is disclosable under the Freedom of Information Act (FOIA) will be disclosed to the public by the Centers for Medicare & Medicaid Services (CMS). When prompted, select 0 for “Other … Such factors include the volume of applications being processed at a given time, whether the application was submitted electronically or on paper, and whether the application was complete and passed all edits. Arkansas Medicaid will use a Taxonomy code only to match an NPI to a legacy Arkansas Medicaid provider ID during EDI processing. If you refer a patient to a physician who submits claims electronically, your NPI will be required to complete their claims. DHS Division of Medical Services, Title XIX (Medicaid) [As required by 42 C.F.R. Added 2/24/21 Arkansas Medicaid released a Section V all provider manuals update. The NPI must also be used on electronic eligibility verification transactions. Provider Enrollment Wizard Tips. What if you have Supplemental Security Income (SSI)? Gainwell Technologies will continue to identify providers that are not eligible for an NPI with their Arkansas Medicaid Provider ID. The National Plan and Provider Enumeration System (NPPES) was elected by the Centers of Medicare & Medicaid Services (CMS) to assign the NPI to eligible health care providers. Box 1437, Slot S401Little Rock, AR 72203-1437, Divisions & Offices:Donaghey Plaza,P.O. Call the NPPES Enumerator at 1-800-465-3203. Yes, if a provider is required to get an NPI, it must be used on the claim for the billing, treating, referring, and attending providers. Arkansas Health & Wellness' plan is called Ambetter. As a result, Arkansas is authorized to provisionally, temporarily enroll providers who are enrolled with another SMA or Medicare for the duration of the public health emergency. Employee Retirement Income Security Act (ERISA) plans, excluding some small self-administered health plans, Military Health System (for active duty and civilian personnel), Health care providers that choose to submit or receive electronic transactions, 06 Autism Specialty AV intensive intervention (group only), 06 Autism Specialty AX lead-line therapist, 06 Autism Specialty AZ clinical services specialist (group only), 15 Transportation Specialty TC non-public transportation, 15 Transportation Specialty TD NET transportation broker, 23 Specialty X2 optical dispensing contractor, 32 Personal Care Specialty P1 private care agency or health agency, 32 Personal Care Specialty PA Area Agency on Aging, 32 Personal Care Specialty PG level 1 assisted living, 32 Personal Care Specialty PS public school or education services, 32 Personal Care Specialty R3 residential care facility, 53 ARChoices Specialty E7 home delivered meals, 53 ARChoices Specialty EC frozen home delivered meals, 54 ARChoices personal emergency response systems, 70 Medicare Health Advantage Plan eligibility only, 72 ACS waiver environmental modifications—adaptive equipment, 73 ACS waiver specialized medical supplies, 82 ACS waiver organized health care delivery system, 86 non-Medicaid provider DDS non-Medicaid, 95 Registered, Noncredentialled Providers Specialty BP board certified behavior analyst paraprofessional, 95 Registered, Noncredentialled Providers Specialty CS community support staff, 95 Registered, Noncredentialled Providers Specialty NT qualified behavioral health provider (QBHP)/personal care aide/non credentialed, 95 Registered, Noncredentialled Providers Specialty NU resident, 95 Registered, Noncredentialled Providers Specialty NV physician assistant, 95 Registered, Noncredentialled Providers Specialty NW non-independently licensed clinicians, 95 Registered, Noncredentialled Providers Specialty RS certified peer recovery support specialist BH/SU, 97 Specialty AT ARChoices traditional agency attendant care, Providers may apply through an easy web-based application process at, The electronic file interchange (EFI) process, also referred to as “bulk enumeration”, allows a health care provider or group of providers to have a particular electronic file interchange organization (EFIO) apply for the NPI on their behalf. If you are interested in submitting claims electronically to Arkansas Medicaid please follow these enrollment instructions. Arkansas Medicaid will not bulk enumerate on behalf of its providers. Arkansas Medicaid Manual: CMS RESPITE CARE Page: Effective Date: 7-1-96 Subject: TABLE OF CONTENTS Revised Date: 8-1-01 SECTION CONTENTS PAGE 140 PROVIDER PARTICIPATION I-19 141 Provider Enrollment I-19 Provider Application - Form DMS-652 I-20 Medicare Verification Form I-23 Electronic Fund Transfer (EFT) Letter I-34 Workgroup for Electronic Data Interchange (WEDI) developed a white paper that may assist in determining an atypical provider. For More Information To verify your address and report your NPI online, log on the Health Care Provider Portal . Since a non-emergency transportation provider cannot get an NPI, the current Arkansas Medicaid Provider ID must be used. For pharmacy providers, “NP” is no longer accepted for the prescriber ID. An atypical provider does not use an NPI; this type of provider must use the Arkansas Medicaid provider number on electronic claims. The NPI is a 10-digit, intelligence-free numeric identifier (10-digit number). Pharmacy providers can obtain a prescriber’s Medicaid ID number by logging on the Health Care Provider Portal. In each provider subsection of the NPI reporting crosswalk tool, the provider number (nine-digit number) displays in the green, red, or blue header, and the status of the provider/NPI record. Arkansas. Provider Enrollment can be reached toll-free at (800) 457-4454 or local at (501) 376-2211. The Registry allows you to search for providers’ NPI numbers. Providers who are not eligible for an NPI will continue to use their Arkansas Medicaid provider ID as always. Depending on family size and income, a person may even qualify for help to pay their monthly premium. The NPI reporting crosswalk tool is a Web-based application that allows providers to report their NPIs to Arkansas Medicaid. More information on EFI can be found at. Yes. The NPI Final Rule issued January 23, 2004, adopted the NPI as this standard. In accordance with the e-FOIA Amendments, CMS has disclosed the data via the Internet. The Arkansas Department of Human Services announced Tuesday it will delay for six months the initial open enrollment period for a new Medicaid … If a provider wants to obtain an NPI, the provider is responsible for either applying directly for an NPI, or as part of another organization’s bulk enumeration process. Enrolled providers must report their NPI to Arkansas Medicaid. You may reach Provider Enrollment or PAC by calling toll-free (800) 457-4454 or local (501) 376-2211. As reported on the CMS website, “We cannot predict the amount of time it will take to obtain a National Provider Identifier (NPI) because several factors come into play. Attendant Care. Examples are pest control, remodeling, chore services, non-emergency transportation providers, and so forth. Box 1437, Little Rock, AR 72203, County Offices:Contact Your County Office, The Official Website of the State of Arkansas, Aging, Adult, & Behavioral Health Services, Find Substance Abuse or Mental Health Treatment, Find Home & Community Based Services for Adults & Seniors, Long-Term Services and Supports (LTSS) Medicaid Assistance, Agency Provider Certification for ARChoices in Homecare, Senior Community Service Employment Program, Challenging Your Background Check Results, Arkansas DHS Criminal Background Check Request Form, Financial Assistance and Resources for Providers, Report a Concern About a Child Care Center, Services for Older Youth or Former Foster Youth, Transitional Employment Assistance (TEA)/Work Pays, Title V: Children with Special Health Needs, Important Points About ARKids First and Medicaid. You should continue to use your Arkansas Medicaid provider ID as you always have. C. Enrollment as a Medicaid provider is conditioned upon approval of a completed provider application and the execution of a Medicaid provider contract. Home > Divisions & Shared Services > Division of Medical Services > Provider Enrollment > National Provider Identifier (NPI) Information. Provider Newsletter - Q2 2019 (PDF) Provider Newsletter - Q1 2019 (PDF) Box 1437, Little Rock, AR 72203, County Offices:Contact Your County Office, The Official Website of the State of Arkansas, Aging, Adult, & Behavioral Health Services, Find Substance Abuse or Mental Health Treatment, Find Home & Community Based Services for Adults & Seniors, Long-Term Services and Supports (LTSS) Medicaid Assistance, Agency Provider Certification for ARChoices in Homecare, Senior Community Service Employment Program, Challenging Your Background Check Results, Arkansas DHS Criminal Background Check Request Form, Financial Assistance and Resources for Providers, Report a Concern About a Child Care Center, Services for Older Youth or Former Foster Youth, Transitional Employment Assistance (TEA)/Work Pays, Title V: Children with Special Health Needs, Important Points About ARKids First and Medicaid. We work with the Arkansas Medicaid Program to help individuals with developmental disabilities or behavioral health needs keep track of their health and maintain their independence. Divisions & Offices:Donaghey Plaza,P.O. For more information about the NPI, view NPI frequently asked questions.