MessagesforRemittanceAdvicesdated–January 28 2016–February 4, 2016
To: Hospital Providers / Re: 24-Day Cap on Inpatient Hospital DaysConcerning inpatient hospital claims for beneficiaries ages 21 and over, for dates of service on or after 1/1/2016: The claims processing system changes for additional days beyond the first 24 days/SFY has not been completed. (See Memorandum Arkansas Medicaid will release a Provider Notification when system changes are completeat which time you may submit any additional claims for the additional days. Continue to obtain MUMP reviews through AFMC as stated in current policy. (See Section 212.500 in the Hospital Manual.)
To: all Providers / RE: Medicaid Eligibility
As part of the eligibility redetermination process, a number of Private Option enrollees have moved to traditional Medicaid. If you feel you have patients that may have shifted into this category, please check their Medicaid eligibility before possible claim submission.
To: ALL PHARMACY PROVIDERS / Re: NEW mac rates
New MAC rates will be implemented 2-15-2016. For more information, please visit the Medicaid Pharmacy website at
TO: Eligible Professionals / RE: EHR Providers to Avoid Medicare Payment Adjustment
CMS has an alternate option for EHR providers to attest in order to avoid Medicare Payment Adjustments (penalties). For more information, visit
To: ALL PROVIDERS / Re: ISSUES RESOLVED WITH ERROR CODES 013 AND 036
All issues regarding Error Code 013/EOB 017 and Error Code 036/EOB 123 have been resolved. Providers may resubmit claims. BILLING REMINDER: For inpatient claims where a delivery condition code is billed, a delivery diagnosis code must be present in the ADMIT Diagnosis field, PRIMARY Diagnosis field, or Diagnosis 1 field. If the delivery diagnosis is not in one of the listed fields, the delivery will not be recognized.
Ifyouneedthismaterialinanalternativeformatsuchaslargeprint,pleasecontacttheProgramDevelopmentandQualityAssuranceUnitat(501)320-6429.
ThankyouforyourparticipationintheArkansasMedicaidProgram.Ifyouhavequestionsregardingthesemessages,pleasecontacttheHewlett Packard Enterprise Provider Assistance Centerat1-800-457-4454(toll-free)withinArkansasorlocallyandout-of-stateat(501)376-2211.
RemittanceAdvicescannotbeforwarded.NotifytheArkansasMedicaidProgramofanyaddresschange,indicatingallprovidernumbersaffectedbythechange.Thisnotificationmustincludetheprovider’soriginalsignature(nofacsimilesaccepted).