Arkansas medical billing involves several key components, including understanding the billing requirements, utilizing the appropriate forms, and ensuring timely processing of claims. Here is a detailed guide to help you navigate the process:Understanding Arkansas Total Care Billing Requirements

1. Provider Manual: The Arkansas Total Care Provider and Billing Manual 2021 outlines the necessary information and procedures for billing and claims submission. It includes details on utilization management, care management, and concurrent review, as well as billing and claims processing.

Billing Forms and Requirements

1. CMS Forms: Arkansas Total Care requires the use of CMS 1450 (UB-04) Claim Form for facilities and CMS 1500 for professionals. These forms must be completed accurately and submitted in the appropriate format (paper, EDI, or secure web-submitted claims).

Verification Procedures

1. Claim Verification: All claims filed with Arkansas Total Care are subject to verification procedures. These include:
   • Completing all required fields on the claim form.
   • Validating claims based on CMS industry standards.
   • Matching member ID and date of birth combinations with participating Arkansas Total Care members.
   • Including the CLIA number when CLIA-waived or CLIA-certified services are provided.

Best Practices for Medical Billing in Arkansas

1. Risk Management: Ensure compliance with risk management policies and procedures to avoid unnecessary upfront rejections or denials.
2. AR Recovery Strategies: Implement effective AR recovery strategies to optimize revenue cycle and improve cash flow.
3. Comprehensive Billing Services: Consider outsourcing to medical billing services that specialize in Arkansas billing, such as Physicians Revenue Group, to ensure superior billing expertise and approach.

Additional Resources

1. Medical Billing and Coding Certification: For those interested in pursuing medical billing and coding certification in Arkansas, there are various resources available, including guides and training programs.

By following these guidelines and best practices, you can ensure accurate and timely medical billing in Arkansas, ultimately improving your revenue cycle and patient care.