We’re a Provider-Led Arkansas Shared Savings Entity (PASSE). The Arkansas Department of Human Services announced Tuesday it will delay for six months the initial open enrollment period for a new Medicaid … No. Transportation is provided only to and from Medicaid-covered services. 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. Enrolled providers must report their NPI to Arkansas Medicaid. To change your demographic information, submit an address change form. Provider Enrollment … (Word, new window) Return to list. Attendant Care. Arkansas Medicaid will read only the NPI on claims unless the provider is atypical. 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. Top 4 provider enrollment issues when applying on the portal. Some examples would be the billing, performing, requesting, attending, referring and prescribing provider number as appropriate for the transaction submitted. Contact us at 501-992-1710 and our friendly staff will help guide you through the process. Guide to the Arkansas Medicaid Program. A “covered entity” is defined as a health care provider, clearinghouse or health plan who conducts standard electronic transactions. How do I determine if my rendering provider needs an NPI or a PIN? 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. Registering your NPI will only create a one-to-one match between the Arkansas Medicaid Provider ID and the NPI. The Arkansas Medicaid Non-Emergency Transportation (NET) program, which is provided through Division of Medical Services (DMS), provides eligible Medicaid clients with transportation to the nearest qualified Medicaid provider. View Private Option/Arkansas Works quarterly and annual reports. For billing related issues with your NPI, contact the Provider Assistance Center (PAC). You cannot remove a rendering provider with the tool. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires the adoption of a standard unique identifier for health care providers. Call the NPPES Enumerator at 1-800-465-3203. 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. Yes. 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. The Registry and the downloadable NPPES data file allow you to search for providers’ NPI numbers. What if you have Supplemental Security Income (SSI)? Go to the NPPES website to view or use the Registry. 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. For Arkansas Medicaid, atypical providers include. Yes. Some examples would be the billing, performing, requesting, attending, referring and prescribing provider number as appropriate for the transaction submitted. You may fax the NPI Reporting Form to (501) 374-0746 ormail it toMedicaid Provider Enrollment Unit – NPIGainwell TechnologiesP.O. You will need to enter your pharmacy Medicaid provider number and your federal tax number to obtain access to the Health Care Provider Portal. Personal Care Webinar Presentation. You do not need to use both. View or print Provider Enrollment contact information. There is no charge to use the NPI Registry. If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or (800) 457-4454. 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). Medicare NPI policy and recommendations are available on the CMS website at https://www.cms.gov/regulations-and-guidance/administrative-simplification/nationalprovidentstand. 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). No. The provider’s NPI does not change and remains with the provider regardless of job or location changes. Yes. Your Arkansas Medicaid provider ID may be given in the REF segment but your NPI will take precedence in our hierarchy. Added 2/24/21 Arkansas Medicaid released a Section V all provider manuals update. Home > Become a Provider > Become a Medicaid Provider. Arkansas currently has the authority to rely upon provider screening that is performed by other State Medicaid Agencies (SMAs) and/or Medicare. We serve participants in the Arkansas Medicaid 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. When prompted, select 0 for “Other … Contact information is required only once for each time a user logs into the system to report NPIs. Links to the Registry and the NPPES data file have been added to the “Helpful Information for Providers” menu for quick access. 1-1-10) 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. What if you have Supplemental Security Income (SSI)? Arkansas Improvements to Medicaid Provider Enrollment Process. 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. For assistance reporting your NPI, please contact the Provider Enrollment Unit. Arkansas Medicaid will use a Taxonomy code only to match an NPI to a legacy Arkansas Medicaid provider ID during EDI processing. If a health care provider’s NPI is used in the case of fraud, a new NPI will be issued. DME Compensation Schedule (PDF) Provider Newsletter. If you are a typical provider, you are required to report your NPI to Gainwell Technologies. The following are examples of subparts: Subparts do not apply to individual providers. Arkansas Medicaid only accepts the National Provider Identifier (NPI) number anywhere a provider number is required on electronic transactions. These “covered entities” must use the standards when conducting any of the defined transactions covered under HIPAA. Provider Enrollment can be reached toll-free at (800) 457-4454 or local at (501) 376-2211. Gainwell Technologies will continue to identify providers that are not eligible for an NPI with their Arkansas Medicaid Provider ID. If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or (800) 457-4454. In order to link your NPI number with your Arkansas Medicaid provider ID, you must register your NPI with Arkansas Medicaid. P.O. (Word, new window) View or print changes to Form DMS-7708, Practitioner Identification Number Request Form. Box 1437, Slot S401Little Rock, AR 72203-1437, Divisions & Offices:Donaghey Plaza,P.O. “Atypical” means non-traditional medical services. If you fail to enter needed information, you will be prompted to provide the missing information. Phone: (800) 457 - 4454 Some examples would be the billing, performing, requesting, attending, referring and prescribing provider number as appropriate for the transaction submitted. What’s New. 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. If you refer a patient to a physician who submits claims electronically, your NPI will be required to complete their claims. Select option 0 for “Other inquiries” and then option 3 for “Provider Enrollment” when prompted. For pharmacy providers, “NP” is no longer accepted for the prescriber ID. Yes. Use only one method, either the paper form or the Web-based NPI reporting crosswalk tool. New Provider Manual Updates. Not all waiver providers are atypical providers. 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. An individual provider may report their NPI independently. No. Personal Care Response System. Using EDI does not determine if the provider is providing health care services or not. State/ Territory State/Territory Provider Enrollment Web Site Link Contact Phone Number(s) Email AK Alaska Provider Enrollment AL. Covered entities are further described as: With the exception of atypical providers, Arkansas Medicaid requires all health care providers (individual, organization, and subparts of an organization) submitting electronic claims to obtain an NPI. You should continue to use your Arkansas Medicaid provider ID as you always have. Provider Enrollment can be reached toll-free at (800) 457-4454 or local at (501) 376-2211. Arkansas Medicaid will only accept the National Provider Identifier (NPI) number anywhere a provider number is required on electronic transactions. Once an entry is submitted using the NPI reporting crosswalk tool, all changes require Gainwell Technologies intervention. What’s new for Arkansas Medicaid providers. Provider Enrollment (800) 457-4454, in-state toll-free or (501) 376-2211 local and out-of-state Go to Provider Enrollment. Provider Information. If a user logs out of the system and logs back in, contact information will be required. 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. If a health care provider is deceased, the NPI will be deactivated. Utilization Review Medicaid Policy and Compliance Provider Enrollment PASSE (Provider-led Arkansas Shared Savings Entity) PASSE Ombudsman ConnectCare Program Pharmacy Services Non-Emergency Medical Transportation (NET) Healthy Smiles Dental Managed Care Vision Program To apply for an NPI through the Internet, go to the NPPES website. The federal government contractor hired to handle the NPI application and issue NPI numbers has not been given permission to release this information to Arkansas Medicaid or other payers. A query-only database, known as the NPI Registry. The health care provider Taxonomy code is a unique, 10-character, alphanumeric code that allows a provider to identify a specialty category. 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. 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. Paper claims submitted with only an NPI will be returned for correction. 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. Groups are allowed to obtain NPIs from their rendering providers and report them to Arkansas Medicaid on the rendering providers’ behalf. Provider Enrollment Revalidation Webinar – Nov. 8, 2018. The following is a list of situations that could occur for a covered entity with an NPI: NOTE: Deactivated NPIs will never be issued to other health care providers. 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. Providers who are not eligible for an NPI will continue to use their Arkansas Medicaid provider ID as always. 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. 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 Wizard Tips. Home > Divisions & Shared Services > Division of Medical Services > Provider Enrollment > National Provider Identifier (NPI) Information. 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). No. From Available Tools select “Report NPI.”. If providers have questions or need assistance with the online application, please contact the Arkansas Medicaid Provider Enrollment Office at (501) 376-2211 … Affiliated provider listing available in the provider portal; Antigen testing For More Information Start a new online application. If you submit paper claims, you must use your Arkansas Medicaid Provider ID. 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. Be sure to get your NPI and report it to Arkansas Medicaid using the Web-based NPI reporting crosswalk tool. (HTML, new window) Return to list Information about NPI Application and Enumeration is available from the NPPES website. Atypical providers must continue to use their Arkansas Medicaid provider ID. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires the adoption of a standard unique identifier for health care providers. Added 4/8/21 Provider Enrollment can be reached toll-free at (800) 457-4454 or local at (501) 376-2211. 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. Examples are pest control, remodeling, chore services, non-emergency transportation providers, and so forth. The Registry allows you to search for providers’ NPI numbers. If you have questions, contact Provider Enrollment toll-free at (800) 457-4454 or local at (501) 376-2211. Select “Demographics Update.” Verify that we have your correct demographic information on file. To enroll as an Arkansas Medicaid provider, the easiest way is to apply online. The NPPES also stores the information about enumerated providers.