Tip: Arkansas Medicaid Provider and Plan Resources

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99MCD1

Nov 17, 2020

Understanding Arkansas Medicaid plans as well as provider and services relationships.

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https://medicaid.mmis.arkansas.gov/Download/Provider/Insider/MMIS_BenefitPlans.pdf - This link provides information about Arkansas Medicaid plans to help the data users understand under what plan services were provided.  For example, if a data user wanted to understand which Medicaid members were eligible for pharmacy benefits before finding the related services, they would need to find members with full benefits by looking at the legacy state aid category/IC benefit plan description look up table in the referenced link. This information should be aligned with ME040 and ME164A in the Member data.  Additional information about the differences between full and partial benefits is also included in the MCD provider manual at the links below.

Several manuals are available providing information about Arkansas Medicaid provider policies.  This information can help data users understand the relationships between the providers and services observed in the claims.

 https://medicaid.mmis.arkansas.gov/Provider/Docs/all.aspx -- the general policies

https://medicaid.mmis.arkansas.gov/Provider/Docs/pharmacy.aspx -- pharmacy

https://medicaid.mmis.arkansas.gov/Provider/Docs/physicn.aspx -- physician

Specific types of Medicaid provider manuals (i.e., AHECs; Ambulatory Surgical Center) can be found here:

Provider Manuals and Other Provider Notifications - Arkansas Department of Human Services

Medicaid

Providers

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