In an effort to resolve claims denied for eligibility, Arkansas Medicaid has made modifications to bypass the timely filing edits. This includes claims beginning with dates of services on and after Oct. 1, 2013. Providers will have between Oct. 17, 2016 through April 15, 2017 to submit these claims.
This is the filing process that must be followed:
- Claims must be submitted electronically.
- Providers must verify that an eligibility segment for the date(s) of service in question is on file.
- A primary care provider (PCP), if required, must be verified and on file before the claim is submitted.
A listing of permissible reasons for qualifying claims may be obtained from Arkansas Medicaid, along with other pertinent information. Claims filed by providers that do not qualify under the identified listing will be reviewed and recouped.
For benefit limits or duplicate services, the first provider that submits a correct claim will be paid first.
Remember, use ICD-9 diagnosis codes for claims BEFORE Oct. 1, 2015 and ICD-10 diagnosis codes for claims AFTER Oct. 1, 2015.
New, revised, and deleted 2017 ICD-10 CM and PCS codes are not yet updated in the Arkansas Medicaid claims processing system. This update is anticipated by Nov. 4, 2016, retroactive to dates of service on and after Oct. 1, 2016. Please hold any claims that would require a new or revised 2017 ICD-10 CM and PCS code, and be aware of any ICD-10 CM and PCS code being deleted in the 2017 ICD-10 code set that would impact billing. All other billing not impacted by 2017 ICD-10 updates can continue to be billed.