Provider Enrollment 2014 HP - Fiscal Agent for the Arkansas Division of Medical Services

Provider Enrollment 2014 HP - Fiscal Agent for the Arkansas Division of Medical Services

Agenda What s New Application Fee Re-Enrollment Online Provider Enrollment Prescriber Enrollment Eligibility HP Contacts 2

What s New Application Fee Re-Enroll Every Five Years Prescriber Enrollment

Application Fee

Application Fee On July 1, 2013, Arkansas Medicaid adopted new enrollment application fee requirements. 5

Application Fee 6

Providers Required to Pay Fee 7 05 Hospital 06 Autism Intensive Intervention Provider 07 Pharmacy 09 Independent Lab 10 Independent Radiology 11 Skilled Nursing Facility 13 Intermediate Care Facility for the Mentally Retarded 14 Home Health 15 Transportation 16 Prosthetic Services 21 EPSDT 23 Optical dispensing contractor 24 Clinics 25 Psychiatric facility inpatient 26 Rehabilitation center (RSPMI) 28 Ambulatory Surgical Center 29 Rural Health Clinic 32 Personal Care 33 Hyperalimentation 34 Hemodialysis 35 Family Planning 36 Domiciliary Care 37 Ventilator Equipment 38 Private Duty Nursing 39 Adult Denture Laboratory 45 School based child health clinic 46 Targeted Case Management 47 Hospice 49 Federally Qualified Health Center 50 ElderChoices Home and Community based 2176 chore services 51 ElderChoices Home and Community based 2176 adult family home 52 ElderChoices Home and Community based 2176 homemaker 53 ElderChoices Home and Community based 2176 home delivered meals 54 ElderChoices Home and Community based 2176 personal emergency response systems 55 ElderChoices Home and Community based 2176 adult day care 56 ElderChoices Home and Community based 2176 adult day health care 57 ElderChoices Home and Community based 2176 respite care 59 School based hearing screener 60 School based vision screener 61 School based vision and hearing screener 63 Targeted Case Management group 64 Hospice physician group 65 TCM organization/facility 66 Hearing aids 67 ACS Waiver Supportive Living/Respite/Supplemental Support 69 AHEC resident group 71 ACS Waiver consultation service 72 ACS Environmental Modifications Adaptive Equipment 73 ACS Waiver specialized medical supplies 74 ACS Waiver Case Management/Transitional Case Management/Community Transition 75 ACS Waiver-Supported employment 76 TCM/CS 77 TCM/DCFS 78 Developmental Rehabilitation Services 82 ACS Waiver Organized Health Care Delivery System 84 APD Environmental adaptations 85 ACS Waiver Crisis Intervention 87 IndependentChoices 88 DYS/TCM organization and rehabilitative services for youth and children 89 DYS/TCM organization and rehabilitative services for youth and children (RSYC) performing 90 Children s services/respite care 91 School based mental health 92 School district outreach for ARKids 93 PACE 94 Assisted Living 96 ElderChoices Home and Community Based 2176 Waiver Adult Companion Services 97 APD, Agency Attendant Care 98 APD, Counseling Case Management 99 Benefit Arkansas and other

Application Fee All providers who must pay the application fee must enroll online. 8

Application Fee The provider is not required to pay the application fee to Arkansas Medicaid if they have done either of the following: Paid the application fee to another state Medicaid program Paid Medicare 9

Application Fee The application fee is subject to change each year. Payments must be paid by credit card, debit card or electronic funds transfer. Proof of payment must accompany the application. 10

Re-Enrollment

Re-Enrollment Arkansas Medicaid adopted new enrollment requirements. All providers will have to re-enroll every five years. 12

Re-Enrollment A notice will be sent by mail 90, 60 and 30 days before the time to re-enroll. 13

Re-Enrollment Enrollment Requirements Individual W-9 forms Contract Disclosure Section IV-group affiliation Electronic Fund Transfer (EFT) Authorization for Automatic Deposit (optional) Change of ownership forms (if applicable) PCP agreement (if applicable) EPSDT agreement (if applicable) Business all the above plus: Secretary of State letter (if applicable) SS4 form or letter from IRS with tax ID (if applicable) 14

Re-Enrollment Documents and Agreements https://www.medicaid.state.ar.us/download/provider/provdocs/manuals/sectionv/section _V.doc W-9 tax form (DMS-652) Medicaid provider contract (DMS-652) PCP agreement, if applicable (DMS-2608 See Section 171.000 for PCP requirements.) EPSDT agreement, if applicable (DMS-831 See Section 201.000 of the EPSDT provider manual for the EPSDT agreement.) Group affiliation form, if applicable (DMS-652). This form is applicable for individual providers who choose to authorize a group to bill and receive reimbursement on their behalf. 15

Online Provider Enrollment

Online Provider Enrollment Go to www.medicaid.state.ar.us. Click on Provider. 17

Online Provider Enrollment 18

Online Provider Enrollment 19

Prescriber Enrollment

Prescriber Enrollment Effective July 1, 2013, a new federal regulation requires that prescribing providers must be enrolled in the state s Medicaid program before a prescription can be paid by Medicaid. 21

Questions?

Eligibility

Determining If A Beneficiary Is... Newly Eligible Enrolled in Traditional Medicaid 24

Determining If A Beneficiary Is Newly Eligible In Transition BCBS Ambetter QualChoice 25

Determining If A Beneficiary Is... Newly Eligible Active QHP Coverage BCBS Ambetter QualChoice 26

HP Medicaid Contacts

HP Enterprise Services Provider Enrollment Monday through Friday (8 a.m. 5 p.m.) Toll-free in Arkansas (800) 457-4454 Local or out-of-state (501) 376-2211 Dedicated fax (501) 374-0746 HP Enterprise Services PO Box 8105 Little Rock, AR 72203-8105 28

HP Enterprise Services Provider Assistance Center (PAC) Your first point of contact for billing, claim status and other general questions is the Provider Assistance Center: Monday through Friday (8 a.m. 5 p.m.) Toll-free in Arkansas (800) 457-4454 Local or out-of-state (501) 376-2211 Please Note: Provider Assistance no longer verifies eligibility. 29

HP Enterprise Services Electronic Data Interchange (EDI) The HP Enterprise Services EDI Support Center assists providers with electronic claim submission issues, 997 batch responses, PES software delivery and setup support, software training and data transmission failures. Monday through Friday (8 a.m. 5 p.m.) Toll-free in Arkansas (800) 457-4454 Local or out-of-state (501) 376-2211 Email Address ARKEDI@HP.COM 30

HP Enterprise Services Research Analyst The HP Enterprise Services Research Analyst answers emails sent to region mailboxes, researches claims issues from providers and submits eligible claims with appropriate override. Providers need to attach a cover letter explaining the reason for their inquiry and attach an original red and white claim form with their cover letter to the address below. HP Enterprise Services Attn: Research Analyst PO Box 8036 Little Rock, AR 72203 31

HP Enterprise Services Provider Representatives Provider representatives handle billing and policy issues that have been escalated from the Provider Assistance Center. They are also available to visit your office by appointment. Don t know who your Provider Representative is? Locate your county on the map in your handouts to see who your Provider Rep is. On the Medicaid website, click on Meet your HP Enterprise Services Provider Rep and then click on your county. 32

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Questions?

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