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Arkansas WebRA Continue to do Amazing Let’s go Green! Don’t wait on the postal service! Is your RA lost in the mail? Save a tree, get it free! At your.

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Presentation on theme: "Arkansas WebRA Continue to do Amazing Let’s go Green! Don’t wait on the postal service! Is your RA lost in the mail? Save a tree, get it free! At your."— Presentation transcript:

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2 Arkansas WebRA Continue to do Amazing Let’s go Green! Don’t wait on the postal service! Is your RA lost in the mail? Save a tree, get it free! At your fingertips!

3 Remittance Advices (RAs) will now be in a PDF format, referred to as WebRAs. Providers will be automatically switched from paper RAs to WebRAs. Providers will be phased in and notified 30 days prior to their implementation date. WebRA Overview

4  Providers will have to register in order to have access to their WebRAs. A link to the registration site will be available through the Provider Portal.  Providers may not receive both paper and WebRAs.  Providers may invite non-providers to have access to their WebRAs.  WebRAs will be mandatory for hospitals and acute care hospitals – no opting out. WebRA Registration

5  Providers who do not have Internet access or have limited access may opt out by submitting a Hardship Waiver form 15 days BEFORE their implementation date.  Providers may opt out after the mandatory 30-day trial period during implementation. Providers may opt out on the Medicaid website. WebRA Registration

6 There are two access points for viewing and downloading WebRAs: Arkansas Medicaid Provider Portal External website (Non-Providers) WebRAs will only be available on the website for 30 days. Viewing/Downloading WebRAs

7 WebRA Screens

8 Account Document Access Invite Non-Providers Document Library Manage The Main Screen has 5 Links:

9 WebRA Main Screen

10 Medicaid Website Welcome back Provider

11 Provider Registration Screen

12 Minimum of 8 characters Contain at least 1 uppercase alpha character Contain at least 1 lowercase alpha character Contain at least one number Contain at least one special Cannot contain the same character more than twice Password Criteria

13 Logon Screen

14 Document Library

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17 WebRA Image

18 Invite Non-Provider Screen

19 You have been invited to view Medicaid Remittance Advice documents by MEDICAL CENTER -SCHOOL, Provider ID: XX. Please make sure this is your correct EIN number: If it is not, request that the provider send another invitation with the correct EIN. Click this link to register (if you haven't already done so).link If the above link does not work, copy and paste this link to your browser's address bar: https://xxxxxxxxxhttps:// If you have already registered, please log on to WebRA to accept or decline the invitation. Non-Provider Invitation

20 Document Access (Provider) XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe

21 Non-Provider Registration Screen

22 Document Access (Non-Provider) XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe XXXXXX John Doe Inc. John Doe

23 Account Screen (Non-Provider)

24 Provider Invitations (Non-Provider) XXXXXX John Doe Inc. XXXXXX John Doe Inc.

25 Log on to Medicaid website Select View WebRA Log on to WebRA with your new secure password View/Download WebRAs Invite Non-Providers Contacts WebRA Review

26 Electronic Data Interchange (EDI) The HP Enterprise Services EDI Support Center is open weekdays from 8 a.m. to 5 p.m. to assist providers with electronic claim submission issues, 997 batch responses, PES software delivery and setup support, software training, and data transmission failures. Toll-free in Arkansas (800) Local or out-of-state (501) Who Do I Contact When I Have a Question about My WebRA?

27 Medicaid Organization

28 County Offices (DCO) Arkansas Foundation for Medical Care (AFMC) ConnectCare QSource Value Options Health Management Systems (HMS) Division of Medical Services (DMS) HP Enterprise Services Arkansas Medicaid Who Does What?

29 Work directly with beneficiaries Determine eligibility, plan description, and eligibility timeframe Assist with Primary Care Physician (PCP) selection DHS County Offices County Case Workers

30 Provides Primary Care Case Management, ARKids, and waiver quality assurance reviews Provides utilization and quality review for various Medicaid Programs Reviews emergency, assistant surgeon, and personal care claims AFMC Review and Authorization

31 Authorizes hospital stays and certain procedures identified by the Division of Medical Services as needing prior authorization Authorizes inpatient stays over 4 days Receives beneficiary comments at: (888) (option 2) AFMC Review and Authorization

32 Enrolls beneficiaries with a PCP Educates beneficiaries, county case workers, and providers about Medicaid (800) ConnectCare Managed Care Helpline

33 Therapy Review, Prior Authorization for Personal Care, and ePrescribing Initiative Address:124 W. Capitol, Suite 900 Little Rock, AR Contact:Nancy Archer, Executive Director Phone: (501) For more information about QSource and the services we provide, please visit us online at QSource of Arkansas Review and Authorization

34 Provides utilization management, continuing education, and inspections of inpatient and outpatient mental health facilities for Medicaid beneficiaries enrolled in the Under 21 Program Approves prior authorizations, Certifications of Need (CON), and Continuing Stay Reviews Receives general questions at: (800) Value Options Mental Health

35 Health Management Systems (HMS) provides services that identify third party payment sources (such as commercial insurance and health plans, Medicare, and TRICARE) and recovers public health plan expenditures when third party liability exists (877) HMS-0184 HMS Third Party Recovery

36 Medical Services – establishes policy for all programs Provider Reimbursement – establishes reimbursement rates TPL – validates Third Party Liability information Program Development and Quality Assurance – distributes policy DMS Administrators of Medicaid

37 Provider Enrollment Claims Processing Remittance Advice Provider Relations Medicaid Management Information System (MMIS) HP Enterprise Services Fiscal Agent

38 What’s New

39 It is called ARRA (American Recovery and Reinvestment Act.) It is a payment incentive program for providers who are using EHR (electronic health records) or EMR (electronic medical records) in an effort to encourage the use of EHR/EMR to improve health outcomes of Arkansas residents. Arkansas Incentive Payment Project

40 The program will have specific criteria each provider must meet as defined as “meaningful use of EHR/EMR.” These criteria are still being defined but an example may be: At least 80% of all unique patients seen by an eligible provider or admitted to the eligible hospital have demographics recorded as structured data. At least 50% of all clinical lab tests ordered whose results are in a positive/negative or numerical format are incorporated in certified (EHR) technology structured data. Arkansas Incentive Payment Project

41 HP is responsible for processing the payments for the Arkansas Incentive Payment Project. Providers must be eligible for this incentive program. An application will be required. o Workshops will be scheduled accordingly. For further information, please refer to https://www.medicaid.state.ar.us/. https://www.medicaid.state.ar.us/ Who Will Process My Payments?

42 Mandatory State use of NCCI requires State Medicaid programs to incorporate “NCCI methodologies” into their claims processing systems. The purpose of the NCCI edits is to prevent improper payments when incorrect code combinations are reported. Arkansas Medicaid will begin using the NCCI edits on April 1, National Correct Coding Initiative (NCCI)

43 Effective January 1, 2012, Arkansas Medicaid will convert to HIPAA X12 version 5010 for electronic transactions. This will include the following: Eligibility (270/271) Claims (837D, P &I) Claims Status (276/277) Prior Authorizations (278) Electronic Remittance Advices (835) Changes to PES and DDE are required to comply with the new standards. Additional information will be available in the upcoming months. If you use a vendor: Testing will be scheduled to begin October 1, Changes will be published in the Companion Guides on the Arkansas Medicaid website prior to testing. Introduction of 5010

44 Monday through Friday (8 a.m. – 5 p.m.) Toll-free in Arkansas (800) Local or out-of-state (501) Dedicated fax(501) Medicaid Provider Enrollment Unit HP Enterprise Services PO Box 8105 Little Rock, AR Dedicated fax (501) HP Enterprise Services

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46 Questions?


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