Arkansas Medicaid — Arkansas Medicaid (ARHOME + PASSE)
| Program name | Arkansas Medicaid (ARHOME + PASSE) |
|---|---|
| Provider portal | https://humanservices.arkansas.gov/divisions/medical-services |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 365 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the Arkansas Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in Arkansas
The Blue Cross Blue Shield Association licensee in Arkansas is Arkansas Blue Cross and Blue Shield (USAble). This licensee is not yet in the QuickIntell payer registry. See the full payer directory or the BCBSA national site for a provider-portal link.
Top commercial payers in Arkansas
The dominant commercial insurers operating in Arkansas, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in Arkansas
Arkansas Medicaid (ARHOME + PASSE) contracts with the following managed-care organizations to administer Medicaid benefits in Arkansas. MCO contracts dictate claims routing, prior-auth workflows, and appeal deadlines — route each claim by the member's MCO assignment, not the state FFS payer ID.
Medicare contractor and active LCDs in Arkansas
Novitas Solutions, Inc. is the Medicare A/B MAC for Arkansas: Part A and Part B fee-for-service claims from Arkansas go to it, and its Local Coverage Determinations decide local medical necessity. Durable medical equipment and supply claims go to CGS Administrators, LLC as the DME MAC. Home health and hospice claims are processed by Palmetto GBA. In the current Medicare Coverage Database export, 141 active LCDs from these contractors apply to Arkansas claims.
- Novitas Solutions, Inc.
A/B MAC (Part A and Part B claims)
- CGS Administrators, LLC
DME MAC (durable medical equipment and supplies)
- Palmetto GBA
Home health and hospice MAC
Selected active Novitas Solutions, Inc. policies for Arkansas
A selection, not the full list: policies with measured search demand come first, then those on topics that more contractors publish LCDs for.
- L35041 Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds
- L34892 Facet Joint Interventions for Pain Management
- L36920 Epidural Steroid Injections for Pain Management
- L39365 Genetic Testing in Oncology: Specific Tests
- L34914 Assays for Vitamins and Metabolic Function
- L35396 Biomarkers for Oncology
- L35010 Trigger Point Injections
- L35038 Scanning Computerized Ophthalmic Diagnostic Imaging
- L34938 Removal of Benign Skin Lesions
- L35138 Routine Foot Care
- L38916 Respiratory Pathogen Panel Testing
- L35006 Controlled Substance Monitoring and Drugs of Abuse Testing
Equipment, home health and hospice policies that apply in Arkansas
- L33822 Glucose Monitors
- L33789 Power Mobility Devices
- L33318 Knee Orthoses
- L33686 Ankle-Foot/Knee-Ankle-Foot Orthosis
- L33718 Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
- L34544 Hospice - Liver Disease
- L34547 Hospice - Neurological Conditions
- L34548 Hospice Cardiopulmonary Conditions
Steps to confirm which LCD governs a claim · Every active LCD by contractor
State-specific regulations affecting Arkansas billing
- Ark. Code §23-99-405 (prompt pay — 30 days electronic clean claim)
- Ark. Act 1040 of 2015 (Healthcare Claim Payment Equity / clean-claim rules)
- Ark. Code §20-9-1301 (hospital financial assistance / charity care)
Provider licensing & enrollment in Arkansas
Providers enroll via Arkansas Medicaid Management Information System (MMIS, Gainwell). PASSE participation requires separate credentialing.
Major health systems headquartered in Arkansas
| Health system | Headquarters |
|---|---|
| Baptist Health (Arkansas) | Little Rock, AR |
| UAMS (University of Arkansas for Medical Sciences) | Little Rock, AR |
| CHI St. Vincent (CommonSpirit) | Little Rock, AR |
| Washington Regional Medical Center | Fayetteville, AR |
| Mercy (Arkansas — Fort Smith) | Fort Smith, AR |
Frequently asked questions — Arkansas billing
What is the Arkansas Medicaid program called?
Arkansas's Medicaid program is known as Arkansas Medicaid (ARHOME + PASSE). Providers enroll and manage claims through the provider portal at https://humanservices.arkansas.gov/divisions/medical-services.
What is the Arkansas Medicaid timely filing limit?
Arkansas Medicaid (ARHOME + PASSE) requires initial claims to be filed within 365 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; Arkansas's 365-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does Arkansas Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for Arkansas Medicaid (ARHOME + PASSE). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in Arkansas?
The dominant commercial payers in Arkansas include UnitedHealthcare, Aetna, Cigna, Humana, Centene, along with the BCBS licensee Arkansas Blue Cross and Blue Shield (USAble). Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in Arkansas?
Arkansas Medicaid (ARHOME + PASSE) contracts with 2 Medicaid MCOs tracked in the QuickIntell registry, including Centene, Anthem (Elevance Health). MCO contracts determine claims routing and appeal deadlines — route each claim by the member's MCO assignment, not by the FFS payer ID.
What state-specific billing regulations apply in Arkansas?
Arkansas has 3 tracked state-level statutes that affect medical billing and RCM: Ark. Code §23-99-405 (prompt pay — 30 days electronic clean claim); Ark. Act 1040 of 2015 (Healthcare Claim Payment Equity / clean-claim rules); Ark. Code §20-9-1301 (hospital financial assistance / charity care). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in Arkansas with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to Arkansas Medicaid (ARHOME + PASSE) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from Arkansas Medicaid and the member ID card before submission.