https //portal.mmis.arkansas.gov/ar medicaid/member : Arkansas Provider Portal

https //portal.mmis.arkansas.gov/ar medicaid/member : Arkansas Provider Portal

On January 1, 2022, Arkansas Works was replaced by the Arkansas Health and Opportunity for Me program, or ARHOME. The ARHOME program uses Medicaid dollars to buy private health insurance for you.

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You’re still covered by Medicaid, but your coverage is provided by one of two private health insurance carriers – Blue Cross Blue Shield or Ambetter.

ARHOME focuses on improving your health, not just providing reliable health care coverage. ARHOME also includes new Life360 HOMEs to focus on the health of certain key groups:

  • Maternal Life360 – High-risk pregnant and new moms, and babies
  • Rural Life360 – Arkansans living in rural communities
  • Success Life360 – Young adults that are at greatest risk for poor health outcomes

ARHOME encourages you to be an active partner with your health care plan and work together to reach your health and well-being goals. A healthy Arkansas is a thriving Arkansas!

If you have any questions about your health care coverage, contact your plan directly or call 1-888-987-1200.

What Services Are Covered By Arkansas Medicaid?

Medicaid pays for a wide range of medical services. The Division of County Operations (DCO) assists in determining if Medicaid pays for a specific service. Many benefits have limits, especially for adults, which may be daily, weekly, monthly or annually. There are also services that have an overall dollar amount limit per time period. Some services require a referral from the clients’ PCPs. Services may be rendered by both private and public providers.

Where Can I See Changes To Policy And Other Provider-Related Notifications?

As new information is issued, provider bulletins and notifications are posted on What’s new for Arkansas Medicaid Providers along with manual updates, official notices and RA messages. Be sure to check this page often for important provider-related information and policy changes.

Claims Questions

Whom Can I Call With A Question About A Claim?

Call the Provider Assistance Center at one of the following numbers:
800-457-4454 toll-free
501-376-2211 local

When Is The Cutoff For Claim Submission?

Claims must be submitted by 6:00 p.m. each Friday in order to be included in the weekly financial cycle. Providers are encouraged to submit claims daily to make sure all claims are accepted before the claim submission cutoff.

For Pharmacy claims processed by Magellan, the claims submission cutoff is midnight each Thursday.

How Can I Check My Claims’ Status?

You can check claim status using the Search Claims option on the Health Care Provider Portal or with the Voice Response System (VRS).

Additionally, you can see the individual claim results on your 835 Electronic Remittance Advice(s), which are produced weekly as they have been in the past.

Trading Partners must select the 276 transaction set in order to receive the claim status response. To get a 277 Response, you must have a 276 Transaction. The MMIS responds to a 276 Claim Status Inquiry with a 277 Claim Status Response(s). You will also be able to view your adjudicated claim using the Health Care Provider Portal; or after the financial cycle each week, you can locate it on your Remittance Advice.

Was My Claim Denied?

The Health Care Provider Portal adjudicates your claims shortly after they are received and tells if your claim will pay, suspend, or deny. If a claim is denied, the system will show the reason under Adjudication Errors.

What If I Find A Mistake In My Claim?

If you realize that a claim contained an error, the error is corrected with an edit, void, or adjustment. Electronic adjustments completed on the Health Care Provider Portal are preferred. Recorded webinars for correctly submitting both institutional claims and professional claims are available to assist you.

How to Check Claim Status

1. Go to the portal landing page and log in using your User ID and password. If you do not have a User ID and password, click Register Now or see the JOB+AID “Registering on the Portal.”

If you have already logged in, skip to step 2.

2. Click on the Claims tab.

3. Click on the Search Claims link.

4. Enter the Claim ID (13-digit number).

NOTE: If the Claim ID or the TCN (formerly known as ICN) is not available, complete the fields in the Beneficiary Information and Service Information fields: Beneficiary ID, Birth Date, Last Name, First Name, Service From and To date, Claim Type, Claim Status and Paid Date.

5. Click Search. HINT: The more information you enter, the better the search.

6. Scroll down to see search results.

7. Click the + sign to see more service line information.

8. Click the Claim ID link if you want to edit, copy, void, print preview or send an inquiry. For more detailed information about how to edit, copy and void a claim, refer to the webinar “Submitting and Reviewing a Claim Form.”

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