The program uses state and federal government funding to provide for the cost of free medicaid benefits in arkansas. Arkansas classified marketplace legal notices legal notices. The software runs on microsoft windows operating systems on ibm compatible computers and will submit a hipaa ready transaction to pennsylvania ma. The seminars will also include information on medicaid s provider electronic solutions software, internet claims submission and billing tips. The 277 claim status responses report is no longer available in. The current version of provider electronic solutions software is 2. The training will take place at the arkansas special education resource center aserc, sherwood, ar, from 9. For individuals ages 19 and older, the arkansas medicaid program will reimburse the pharmacy the cost of administering, by injection or intranasal use, two types of. All providers, portal billing for pes users webinar hmtl, new window.
Assisted in testing provider electronic submission pes software. July 9, 2015 the breastcare program arkansas medicaid arkansas department of health, serving arkansas since 1999. Each plan has already received a list of providers that meet this contracting types of billing and to provide clinical guidance in the provision of these services. Program development and quality assurance distributes medicaid policy and. Provider electronic solutions pes software arkansas. Though weve already processed millions of claims, we know that medicaid. If you currently use pes, do not load a new, full version of the software or your claim data and lists will be deleted. Vendor trading partner agreement an edi trading partner is an entity provider, billing service, clearinghouse, software vendor, etc. Arkansas medicaid solace electronic medical claims. Provider electronic solutions software download page. Provider electronic solutions software users manual the newest version v4. Arkansas medicaid provider electronic solutions pes. Requirement for the pv specialty is proof of medicare enrollment. Added 32520 arkansas medicaid has released final rule 96 state plan amendment 2020007.
Pharmacy provider file must reflect a specialty code of pv pharmacy administered. Pharmacy must be a currently enrolled arkansas medicaid provider. In preparation for this transition, many activities leading up to november 1 will be taking place. Dxc technologys medicaid software, provider electronic solutions pes, enables health care providers to verify beneficiary eligibility, request prior. The office of medical assistance programs has made the provider electronic solutions software and user manual available for download freeofcharge from this website. Evaluation of the arkansas medicaid primary care physician. To apply for an ar medicaid electronic submitter id, please go to the following website. Arkansas payment improvement initiative 866 3224696 instate tollfree or 501 3018311 local and outofstate magellan medicaid administration pharmacy help.
Box 1437, slot s295, little rock, arkansas 72203 1437. The new mmis system, which is what we at dhs use to pay medicaid claims and much more, officially went live on wednesday. A user guide for hp provider electronic solutions software v. Arkansas medicaid is a health program managed by the state of arkansas and jointly funded by state and federal dollars.
Checklist for waivers hcbs information on denials, reasons for recoupments, where to find information in the medicaid provider billing manual, free tools and contacts for providers to use in. Arkansas medicaid enterprise dxc technology provider. Individual workshops focusing on professional service providers, dental and longterm care. Medicaid enrollees, where appropriate, have been denied by medicare prior when multiple scans are needed use the same procedure code and enter two as of february 1, 2015, a new user agreement for cwqi is available. Provider electronic solutions pes software medicaid provider. During testing for the hipaa remediation project, learned to read and interpret ansi x12 implementation guide and standards. Arkansas childrens hiring account analyst i biller. If you are interested in submitting claims electronically to arkansas medicaid please follow these enrollment instructions. Aug 16, 2017 the commonwealth of virginias medicaid web portal is a web based system that gives type code drop down list and entry of icn, the populate with. They are intended for vendors that design software or systems for submitting health care transactions electronically to arkansas medicaid. Arkansas medicaid providers and beneficiaries rely on a mmis for provider.
Promoting interoperability pi program arkansas medicaid. The cd will include provider electronic solutions pes software, relevant web links, and other provideroriented information. However, because pes software will be decommissioned, providers who use pes are strongly encouraged to transition to the arkansas medicaid healthcare. Dvha would like to clarify the banner posted on friday, 4. Dxc technologys medicaid software, provider electronic solutions pes, enables health care providers and retail pharmacies to verify. This is the new way claims will transmitted to medicaid.
Dxc technologys medicaid software, provider electronic solutions pes, enables health care providers and retail pharmacies to verify beneficiary eligibility, request prior. Providers should be using the most current version of the pes software. Dds acs waiver provider automated prior authorization process. Through all of our initiatives, the division of medical services number of claims processed and approximate processing time.
Pennsylvania medical assistance ma has made the provider electronic solutions software available freeofcharge to the pennsylvania provider community. Officials of the arkansas medicaid program and eds, the state medicaid contractor, decided. Before a provider upgrades their pes software, they need to make a copy of their database file. Pes troubleshooting notes welcome to arkansas medicaid. Downloading files after files are successfully uploaded, the files should be checked to make sure they have passed validation requirements i. Claim form billing instructions magellan rx management. Uploading files from the pes software is accomplished via the software by clicking communication, submission i.
The arkansas medicaid pcp program exempts 30 percent of all medicaideligible persons from participation. All arkansas medicaid batch billers should have received a letter from hp enterprise services detailing the change in how batch billing files are submitted to arkansas medicaid. New mmis healthcare portal official golive date is november 1, 2017. If you currently use pes, you must upgrade to version 2. Where do i upload batch files created in facilityspecific billing software.
Arkansas upgrade to a new medicaid management information. Once validated, the pa request is routed to pam and will appear on the pam pa queue. Arkansas medicaid program helps needy individuals pay for basic and necessary medical services living in arkansas and meeting the program eligibility guidelines. Arkansas medicaid provider electronic solutions pes handbook. The official web page for the medicaid pi program for arkansas providers. The removal of the references to the pes software affects most of the provider manuals. Claims may be submitted electronically if the pharmacys vendor software can code and. Vendor software that meets the requirements of the health insurance portability and accountability act hipaa for the transmission of electronic transactions or provider electronic solutions software, v 2.
Provider assistance center 800 6887989 nationwide tollfree or 334 2150111. Frequently asked questions arkansas medicaid arkansas. Arkansas medicaid reserves the right to monitor andor limit access to this resource at any time. Dhss local county offices are the point of contact and primary resource for medicaid beneficiaries and applicants. Through this portal, providers, managed care organizations, partners, and trading partners can electronically and securely submit, manage, and maintain health records for members under their care. Medicare and medicaid issues arkansas attorney general. Provider electronic solutions has an easytouse online help tool that can be activated at the.
The tollfree nonemergency transportation helpline 18889871200, option 1 takes beneficiaries questions, comments, complaints and suggestions about the net program. Several arkansas medicaid provider manuals contain references to outdated programs, services, software, terminology, and website links. Download pes software or upgrade your version from this website. Medicare, arkansas medicaid, various outofstare medicaid programs, blue cross blue shield, qualchoice, etc. October 2, 2014 contents office of personnel management documents available from the center for medicare and medicaid services that. Provider electronic solutions pes software alabama medicaid. July 9, 2015 prescription drug program prior authorization criteria arkansas revised 2272015 arkansas medicaid preferred drug list may be found at. Provider electronic solutions pes software arkansas medicaid. Workshop 2015 serves as a liaison for medicaid and providers. Bug fixes and system changes that necessitate a new pes release may cause issues with older versions of pes software. Always use the upgrade function to keep pes software current. Please complete the registration information below and then select submit request. Claims may be submitted electronically using hps pes software, or the provider may log. Hps medicaid software, provider electronic solutions pes, enables health care providers and retail pharmacies to verify beneficiary eligibility, request prior authorizations, and submit claims electronically.
Medicaid billingpes software training for billing clerks, admin. Pes troubleshooting notes arkansas medicaid arkansas. Alabama medicaid requires all trading partners to complete edi registration. However, because pes software will be decommissioned, providers who use pes are strongly encouraged to transition to the arkansas medicaid healthcare provider portal before their software becomes obsolete. The cd also gives users the capability to search one or all provider manuals. Eds provider representatives will be facilitating the workshop focusing on. Arkansas medicaid pes handbook 011912 7 what is pes. Dds acs waiver provider automated prior authorization. Provider electronic solutions is a proprietary windowsbased software that enables providers to submit claims electronically, receive claim status, and verify member eligibility in a batch mode. The hipaa compliant software the current full install is version 3.
Front line system status site map beneficiary general. View or print arkansas medicaid provider portal application instructions. The forwardhealth portal serves as the interface to forwardhealth interchange, the medicaid management information system for the state of wisconsin. Prior authorizations end dates covid19 clarification.
1217 1524 925 471 375 770 1313 1110 271 473 1398 424 115 1231 1215 1028 1175 1221 948 293 637 237 109 1182 388 634 1217 683 964 377 1402 1346 590 1021 339 342 1380 1410 290 94