State · AR
Medical billing services in Arkansas
Short answer
Medical billing services in Arkansas deal with a Medicaid program that still pays most claims fee-for-service: CMS counted 89 percent of Arkansas Medicaid enrollees in some managed care arrangement in 2024 but only about 5 percent in full-benefit plans, the four PASSE entities, while primary care case management covers most of the rest. Dental runs through two dental plans and rides through regional contractors.
CMS last listed home health EVV as non-compliant as of January 1, 2024, and DHS's October 2025 guidance has home health EVV claims carry the rendering clinician's NPI or PIN. A Remitwright dedicated biller tracks which program holds each patient, serving Arkansas practices remotely. Rules for other states are on the medical billing services by state page.
Last reviewed by the Remitwright billing team. Editorial policy
Billing in Arkansas: what's different
The rules below change how a claim is filed and paid in Arkansas. Each line links to the official page it was read from, and the date at the top of this page is when it was last checked.
| Fact | In Arkansas | Source |
|---|---|---|
| Medicaid program | Arkansas MedicaidArkansas Department of Human Services, Division of Medical Services | 13 |
| Fee-for-service portal | Arkansas Medicaid MMIS provider portal | 13 |
| How Medicaid is delivered | Mostly fee-for-service | 1 |
| Managed care plans | 6 plansArkansas Total Care (Centene), CareSource PASSE, Beacon's PASSE entity, Summit Community Care (Anthem), Delta Dental Smiles, MCNA Dental | 2 |
| Medicaid timely filing (federal outer limit) | 12 months from the date of service | 7 |
| Medicaid MCO prompt pay | 42 CFR 447.46 (timely claims payment by MCOs) | 8 |
| NEMT | Regional contractor model | 2 |
Arkansas Medicaid
Arkansas Medicaid is run by the Arkansas Department of Human Services, Division of Medical Services. Fee-for-service claims and provider enrollment go through the Arkansas Medicaid MMIS provider portal13, at portal.mmis.arkansas.gov. Mostly fee-for-service: CMS counted 803,185 of Arkansas's 900,323 Medicaid enrollees, 89.2 percent, in some managed care arrangement as of July 1, 2024, but only 48,668, 5.4 percent, in full-benefit managed care, the PASSE program1. The rest of the managed care count is the primary care case management program, dental managed care and the nonemergency transportation contractors, none of which takes over the payment of a medical claim.
Medicaid timely filing (federal outer limit): No later than 12 months from the date of service: 42 CFR 447.45(d)(1) requires every state Medicaid agency, Arkansas's included, to make providers submit all claims within that window7. The same rule has the agency pay 90 percent of clean claims from practitioners within 30 days of receipt and 99 percent within 90 days. Each PASSE plan sets its own filing limit in its provider manual.
Managed care plans2
- Arkansas Total Care (Centene)PASSE, 13,394 members in CMS's 2024 plan file
- CareSource PASSEPASSE, 3,923 members in 2024
- Beacon's PASSE entityPASSE, 15,895 members in 2024, with Beacon as its parent organization in CMS's plan file
- Summit Community Care (Anthem)PASSE, 14,657 members in 2024
- Delta Dental SmilesAR Healthy Smiles dental plan, 307,358 members in 2024
- MCNA DentalAR Healthy Smiles dental plan, 289,659 members in 2024
Each plan is credentialed separately, has its own portal and its own appeal route. A practice that joins Arkansas Medicaid through one plan is not in network with the others until each contract is in place.
Commercial payers and plan payment standards
Commercial payers active in Arkansas4: Arkansas Blue Cross and Blue Shield, Health Advantage, Ambetter from Arkansas Health & Wellness, Octave. Each has its own filing window, corrected-claim process and appeal levels in its provider manual, and the timely filing limits table lists verified payer deadlines with their sources.
For Medicaid managed care, the clean-claim payment standard under 42 CFR 447.46 (timely claims payment by MCOs): 90 percent of clean claims from practitioners paid within 30 days of receipt and 99 percent within 90 days, unless the plan and the provider agree to another schedule in their contract8. Section 447.46 has every MCO contract carry that standard. Why it reaches the four PASSE entities is set out in the PASSE rule below, which gives the program's MCO classification. In A/R follow-up, a managed care claim that is past that standard is raised with the plan, with the contract term cited.
NEMT and home care in Arkansas
Non-emergency medical transportation. Regional contractor model: CMS's 2024 plan file lists Southeast Trans, Central Arkansas Development and the Area Agency on Aging of Southeast Arkansas as the Arkansas nonemergency transportation contractors, with 571,500, 135,267 and 70,362 enrollees respectively2. The program's authority, start date and pre-assignment rule are set out in the rules below. The NEMT billing in Arkansas page covers trip documentation, broker claims and reconciliation.
Electronic visit verification. CMS found Arkansas fully compliant with the Cures Act EVV requirement for personal care services as of April 1, 2021, when 1915(j) self-directed personal attendant care joined the authorities in its January 13, 2021 determination9. CMS reserves the right to apply FMAP reductions if the state's system does not match its attestation. Home health is a different picture, covered in the rules below. See home care billing in Arkansas for waiver programs, EVV exceptions and authorizations.
Rules that change how Arkansas claims are billed
PASSE is the only full-benefit managed care, and most other members sit in PCCM3
CMS's 2024 state tables describe the Provider-led Arkansas Shared Savings Entity program as a statewide full-benefit MCO program with long-term services and supports, running since October 1, 2017 under 1915(b) with 1915(c) and 1915(i) authority and a 90-day enrollment choice period. Its population tables do not list low-income adults, children and most other groups as mandatory PASSE populations, so a practice sees PASSE members mainly in behavioral health and developmental disability care. The same tables show the PCCM program running statewide since January 1, 2014 under 1932(a) authority, with AFMC as its enrollment broker, and AR Healthy Smiles as a statewide dental-only prepaid plan since January 1, 2018. A PCCM assignment changes who the patient's primary care provider is, not who pays, so the state stays the payer for most Arkansas Medicaid visits.
NET has run regionally since 1998, with members pre-assigned3
CMS's 2024 state tables list Non-Emergency Transportation as a statewide program that started August 26, 1998 under 1915(b) and 1902(a)(70) authority, with its waiver running to March 31, 2028. Enrollment is mandatory for expansion adults, aged, blind or disabled members, children, full duals and children with special health care needs, and members are pre-assigned rather than choosing a contractor, so the contractor follows the member's region and the practice does not pick one.
CMS found home health EVV non-compliant on December 29, 202310
CMS's December 29, 2023 letter to the Arkansas Department of Human Services found the state non-compliant with the Cures Act EVV requirement for section 1905(a)(7) home health care services. The state told CMS it was securing an alternative EVV vendor and expected compliance by July 1, 2024, and CMS applied FMAP reductions from the first quarter of 2024 that step up from 0.25 percentage points in 2024 to 1 point in 2027 and later years for each quarter the state stays non-compliant. That is the federal finding; the claim rule DHS set out for home health EVV in 2025 follows.
DHS's 2025 billing guidance: home health EVV claims carry the rendering clinician's NPI or PIN6
The Arkansas Department of Human Services' Billing and MMIS presentation of October 23, 2025 says home health providers must include specific information with each claim or encounter for services subject to EVV: the Performing Provider ID field holds the NPI or PIN of the individual who rendered the service, whatever the provider type. Provider type 95/NT uses the PIN and provider types 21/TP and 21/T1 use the NPI, and the presentation's October 2025 portal screens show a claim stopped with an error when a Medicaid ID is entered where a healthcare provider's NPI belongs. A home health EVV claim that names only the agency is missing the field this guidance requires.
A PASSE claim has 365 days, and PASSE EVV runs through HHAeXchange12
Arkansas Total Care's 2026 Provider and Billing Manual gives providers 365 calendar days from the date of service, the inpatient discharge date or the date the provider learned the member's PASSE, and 365 days from the primary payer's explanation of payment when it pays second; it will not deny for timeliness when the delay came from a provider's reasonable efforts to determine liability. Its EVV visits, required for dates of service from December 1, 2022, go through HHAeXchange or a third-party system that aggregates with it, and a valid Arkansas Medicaid provider ID is needed to submit them.
Enrollment and revalidation run through the provider portal6
The Arkansas Department of Human Services' Billing and MMIS presentation of October 23, 2025 says initial provider enrollment applications, except those from long-term care facilities, must be submitted electronically through the provider portal, and that revalidation is due every five years for every provider type except Provider Type 95. The Arkansas Medicaid Provider Portal sends a letter before an enrollment expires, providers are told to revalidate at least 60 days ahead, and all documentation has to arrive before the expiration date, so a lapsed enrollment is a billing problem a biller can see coming.
Services for Arkansas practices
Remitwright serves Arkansas practices remotely, inside the practice management or EHR system the practice already uses. A dedicated biller works the account; nothing is pooled. Each service below explains what that biller does.
- Medical billingClaims worked by one named biller
- CredentialingEnrollment, CAQH and PECOS kept current
- Eligibility verificationCoverage and benefits checked before visits
- Prior authorizationAuths requested, tracked, attached to claims
- Denial managementEvery denial read, worked and appealed
- A/R follow-upUnpaid claims chased before filing limits
FAQ
Questions from Arkansas practices
Which Arkansas Medicaid programs are managed care, and which are fee-for-service?
What is the Arkansas Medicaid timely filing limit?
Does Arkansas require EVV for home care visits?
Who arranges Medicaid transportation in Arkansas?
Which commercial payers did you list for Arkansas, and why those?
Where do Arkansas Medicaid fee-for-service claims go?
What does the primary care case management assignment change for a claim?
Which managed care plans run Medicaid in Arkansas?
How quickly must Arkansas Medicaid managed care plans pay a clean claim?
Next step
Get a billing review for your Arkansas practice
Three quick questions, no patient data. Tell us your payers and we reply in writing with what we would check first.
- Three questions, about two minutes
- No patient data, no software to buy
- A written reply from a biller, not a sales deck
You answer three questions
A billing specialist reads them
A written reply by email
Prefer email? sales@remitwright.com
Request received
Thanks. Your review request is in.
Reference . Quote it if you write to us about this request.
- A billing specialist reads your answers and replies by email.
- If a look at real claims makes sense, we agree read-only access under a BAA first.
- You get a written summary of what is worth working and what it would take. No commitment.
While you wait: see the sample weekly report or read how switching works. You can also download the sample weekly report (PDF).