1. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 1 Living Choices Assisted Living Summer 2015 HP – Fiscal Agent for the Arkansas Division of Medical Services

2. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 2 Topics for Today Provider Training Provider Manuals Submitting Claims Claim Adjustments and Voids Current CPT Codes and Place of Service Codes Timely Filing WebRA ICD-10 Provider Enrollment Frequently Asked Questions HP Enterprise Services Contacts Questions

3. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 3 Provider Training

4. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. Arkansas Medicaid Website www.medicaid.state.ar.us

5. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 5 Arkansas Medicaid Website - www.medicaid.state.ar.uswww.medicaid.state.ar.us Provider Training

6. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 6 Arkansas Medicaid Billing 101(includes Arkansas Medicaid Passwords and WebRA) PES Billing 101 (Provider Solutions Software)/DDE Demonstration (Arkansas website data entry) Virtual Classes Provider Training

7. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 7 Training Materials Provider Training Training Materials from Past Workshops Arkansas Medicaid Billing Guides Billing Tips

8. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 8 Arkansas Medicaid Website - www.medicaid.state.ar.uswww.medicaid.state.ar.us Provider Training

9. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 9 Provider Workshops Provider Training Provider workshops will be posted under the Provider Training tab with a link to register for the workshop. Workshops are usually posted 14-28 days before the workshop date. Workshop invitations are also mailed to providers 14-28 days before the workshop date.

10. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 10 Provider Manuals

11. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 11 Section I General Policy General information, sources, beneficiary eligibility and responsibilities, provider participation, administrative (and non-compliance) remedies and sanctions, and PCP case management program and required services and activities Section II Provider Manual (varies by provider type) Program or provider specific information, program coverage, prior authorization, reimbursement and billing procedures Provider Manuals Sections

12. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 12 Section III Billing Information General information, Remittance Advice (RA) and status report, adjustment request, additional or other payment sources, pseudo claims and reference books Section IV Glossary AR Medicaid acronyms and terms Section V Claim Forms Claim forms, AR Medicaid forms, contacts and links Provider Manuals Sections

13. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 13 Appendix A Update Log Number and release dates for updates Transmittal Letters, Official Notices, RA Messages Provider Manuals Sections

14. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 14 Submitting Claims

15. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 15 Claims on Paper Direct Data Entry (DDE) Provider Electronic Solutions (PES) Your Vendor Software Ways to Submit Claims

16. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 16 Claim Adjustments and Voids

17. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 17 Paper Adjustments A legible signature must be on the adjustment form.

18. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 18 Paper Adjustments Paper adjustment request forms are found on the Arkansas Medicaid website in the Section V provider manual. You may print adjustment forms as needed. Paper adjustment requests should be mailed to: Arkansas Medicaid Attn: Adjustments P.O. Box 8036 Little Rock, AR 72203

19. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 19 Once you are logged on, your provider name will appear under “Welcome Back.” To start a new claim, click on “Professional Claim.” To void or adjust a previous claim, click on “Professional Claim reversal.” Direct Data Entry (DDE) Arkansas Medicaid Website - www.medicaid.state.ar.uswww.medicaid.state.ar.us

20. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 20 Direct Data Entry (DDE) Arkansas Medicaid Website - www.medicaid.state.ar.uswww.medicaid.state.ar.us

21. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 21. Direct Data Entry (DDE) Arkansas Medicaid Website - www.medicaid.state.ar.uswww.medicaid.state.ar.us

22. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 22 Direct Data Entry (DDE) Arkansas Medicaid Website - www.medicaid.state.ar.uswww.medicaid.state.ar.us

23. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 23 Provider Electronic Solutions (PES) Software Provider Electronic Solutions software is HP’s free eligibility and claims submission software. It is available for download from the Arkansas Medicaid website. You may do submits, adjustments and voids using PES.

24. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 24 Provider Electronic Solutions (PES) Software

25. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 25 Provider Electronic Solutions (PES) Software

26. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 26 Provider Electronic Solutions (PES) Software

27. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 27 When submitting, adjusting and voiding claims in PES, be sure to pull back your response report to see rejections and claims accepted. Provider Electronic Solutions (PES) Software

28. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 28 Current CPT Procedure Codes and Place of Service Codes

29. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 29 Assisted Living CPT Procedure Codes Procedure CodeModifiersDescription T2031U1Living Choices Assisted Living Tier 1 T2031U2Living Choices Assisted Living Tier 2 T2031U3Living Choices Assisted Living Tier 3 T2031U4Living Choices Assisted Living Tier 4

30. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 30 Assisted Living Place of Service Codes Electronic and paper claims now require the same National Place of Service Codes. The only Place of Service Code applicable to Living Choices Assisted Living is 12, “Home.”

31. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 31 Timely Filing Medicare/Medicaid Crossover Claims and Claims with Retroactive Eligibility (Pseudo Claims)

32. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 32 Timely Filing Medicaid requires providers to submit all claims no later than 12 months from the date of service. The 12-month filing deadline applies to all claims, including: Claims for services provided to recipients with joint Medicare/Medicaid eligibility Adjustment requests and resubmissions of claims previously considered Claims for services provided to individuals who acquire Medicaid eligibility retroactively

33. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 33 Retroactive eligibility does not constitute an exception to the filing deadline policy. If an appeal or other administrative action delays an eligibility determination, the provider must submit the claim within the 12-month filing deadline. If the claim is denied for recipient ineligibility, the provider may resubmit the claim when the patient becomes eligible for the retroactive date(s) of service. Medicaid may then consider the claim for payment because the provider submitted the initial claim within the 12-month filing deadline and the denial was not the result of an error by the provider. To resolve this dilemma, Arkansas Medicaid considers the pseudo recipient identification number 9999999999 to represent an “...error originating within (the) State’s claims system.” Therefore, a claim containing that number is a clean claim if it contains all other information necessary for correct processing. Claims With Retroactive Eligibility (Pseudo Claims) Timely Filing

34. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 34 Providers have 12 months from the approval date of the patient’s Medicaid eligibility to resubmit a clean claim after filing a pseudo claim. After the 12-month filing deadline (12 months from the Medicaid approval date), claims will be denied for timely filing and will not be paid. It is the responsibility of the provider to verify the eligibility approval date. Once a beneficiary receives retro eligibility, the provider must submit a paper claim, proof of the Pseudo claim, and a cover letter to Research for special processing. HP Enterprise Services Attn: Research Analyst PO BOX 8036 Little Rock, AR 72203 Claims With Retroactive Eligibility (Pseudo Claims) Timely Filing

35. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 35 WebRA

36. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 36 WebRA

37. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 37 WebRA

38. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 38 Your name will appear here after you log on. Let’s open WebRA. WebRA

39. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 39 Effective July 2011, ALL providers should be retrieving WebRAs from the Arkansas Medicaid website. Remittance Advices (RAs) are in a PDF format, referred to as WebRAs. WebRAs will only be available on the website for 35 days. A charge will apply for RAs requested after the 35-day period. For WebRA training, refer to the Provider Training link on the Medicaid website. Overview WebRA

40. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. ICD-10 Provider Testing

41. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 41 ICD-10 Provider Testing ICD-10 provider testing is available for Arkansas Medicaid now through August 31 st. We encourage you to take advantage of this opportunity to avoid disruptions related to the transition to ICD-10 on October 1, 2015. Register at: http://icd10cbt.com/moodle/.http://icd10cbt.com/moodle/

42. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 42 ICD-10 Provider Testing All claims submitted to Arkansas Medicaid for Dates of Service on and after 10/1/15 must bill using ICD-10 codes. Feel free to contact Arkansas Medicaid for assistance. With more than 38,000 providers, we expect a high volume of inquiries and possible delays in responses.

43. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 43 ICD-10 Provider Testing Testing with HP will ONLY be available through August 31, 2015! To access testing information and directions, refer to: http://humanservices.arkansas.gov/dms/Pages/ICD-10.aspx

44. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 44 Your facility may be ready for ICD-10 if: ICD-10 Provider Testing You have contacted your software vendors and your upgrades are completed. You have identified, remediated and tested all of your IT systems, including EMR, Practice Management and Reporting. You have conducted testing with your large-volume payers, including AR Medicaid and HP. You understand where ICD-9 codes may be embedded in your operational processes and all areas have been remediated – including the reports you my generate or use regularly. You have identified your top 25 diagnoses. You have translated those diagnoses and understand the need for additional documentation to support the diagnoses.

45. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 45 General ICD-10 Information Please visit this website for more information: http://humanservices.arkansas.gov/dms/Pages/ICD-10.aspx

46. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 46 Provider Enrollment Frequently Asked Questions

47. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. Frequently Asked Questions…. Q:What is the reason for the application fee? A:This federally-mandated fee will be used to offset the cost of conducting new screening activities associated with the ACA.

48. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 48 Application Fee On July 1, 2013, Arkansas Medicaid adopted new enrollment application fee requirements. The Centers for Medicare & Medicaid Services (CMS) sets the application fee amount, which may vary or be adjusted from year to year and is payable every five (5) years.

49. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 49 Providers Required to Pay Fee 05 – Hospital 06 – Autism Intensive Intervention Provider 07 – Pharmacy 09 – Independent Lab 10 – Independent Radiology 11 – Skilled Nursing Facility 13 – Intermediate Care Facility for the Mentally Retarded 14 – Home Health 15 – Transportation 16 – Prosthetic Services 21 – EPSDT 23 – Optical dispensing contractor 24 – Clinics 25 – Psychiatric facility—inpatient 26 – Rehabilitation center (RSPMI) 28 – Ambulatory Surgical Center 29 – Rural Health Clinic 32 – Personal Care 33 – Hyperalimentation 34 – Hemodialysis 35 – Family Planning 36 – Domiciliary Care 37 – Ventilator Equipment 38 – Private Duty Nursing 39 – Adult Denture Laboratory 45 – School based child health clinic 46 – Targeted Case Management 47 – Hospice 49 – Federally Qualified Health Center 50 – ElderChoices Home and Community based 2176 – chore services 51 – ElderChoices Home and Community based 2176 – adult family home 52 – ElderChoices Home and Community based 2176 – homemaker 53 – ElderChoices Home and Community based 2176 – home delivered meals 54 – ElderChoices Home and Community based 2176 – personal emergency response systems 55 – ElderChoices Home and Community based 2176 – adult day care 56 – ElderChoices Home and Community based 2176 – adult day health care 57 – ElderChoices Home and Community based 2176 – respite care 59 – School based hearing screener 60 – School based vision screener 61 – School based vision and hearing screener 63 – Targeted Case Management group 64 – Hospice physician group 65 – TCM organization/facility 66 – Hearing aids 67 – ACS Waiver Supportive Living/Respite/Supplemental Support 69 – AHEC – resident group 71 – ACS Waiver consultation service 72 – ACS Environmental Modifications Adaptive Equipment 73 – ACS Waiver specialized medical supplies 74 – ACS Waiver Case Management/Transitional Case Management/Community Transition 75 – ACS Waiver-Supported employment 76 – TCM/CS 77 – TCM/DCFS 78 – Developmental Rehabilitation Services 82 – ACS Waiver Organized Health Care Delivery System 84 – APD Environmental adaptations 85 – ACS Waiver Crisis Intervention 87 – IndependentChoices 88 – DYS/TCM organization and rehabilitative services for youth and children 89 – DYS/TCM organization and rehabilitative services for youth and children (RSYC) performing 90 – Children’s services/respite care 91 – School based mental health 92 – School district outreach for ARKids 93 – PACE 94 – Assisted Living 96 – ElderChoices Home and Community Based 2176 Waiver – Adult Companion Services 97 – APD, Agency Attendant Care 98 – APD, Counseling Case Management 99 – Benefit Arkansas and other

50. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 50 The Application Fee Is subject to change each year. Proof of payment must accompany the application. Must be paid by credit card, debit card or electronic funds transfer through the Medicaid website.

51. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 51

52. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. Frequently Asked Questions…. Q:How do I apply for a Provider Number? A:Applications can be done electronically through the Medicaid website or on paper.

53. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 53 Medicaid Application

54. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 54 Medicaid Application

55. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 55

56. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. Frequently Asked Questions…. Q:Who should I talk to for questions or concerns with my application? A:The Provider Enrollment Department.

57. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 57 HP Enterprise Services Contacts

58. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 58 Monday through Friday (8 a.m. – 5 p.m.) Toll-free in Arkansas (800) 457-4454 Local or out-of-state (501) 376-2211 Dedicated fax (501) 374-0746 HP Enterprise Services PO Box 8105 Little Rock, AR 72203-8105 HP Enterprise Services Provider Enrollment

59. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 59 Your first point of contact for billing, claim status, and other general questions is the Provider Assistance Center: Monday through Friday (8 a.m. – 5 p.m.) Toll-free in Arkansas (800) 457-4454 Local or out-of-state (501) 376-2211 Please Note: Provider Assistance no longer verifies eligibility. HP Enterprise Services Provider Assistance Center (PAC)

60. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 60 The HP Enterprise Services EDI Support Center assists providers with electronic claim submission issues, 997 batch responses, PES software delivery and setup support, software training and data transmission failures. Monday through Friday (8 a.m. – 5 p.m.) Toll-free in Arkansas (800) 457-4454 Local or out-of-state (501) 376-2211 Email AddressARKEDI@HP.COMARKEDI@HP.COM HP Enterprise Services Electronic Data Interchange (EDI)

61. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 61 HP Enterprise Services Research Analyst The HP Enterprise Services Research Analyst answers emails sent to region mailboxes, researches claims issues from providers and submits eligible claims with appropriate override. Providers need to attach a cover letter explaining the reason for their inquiry and attach an original red and white claim form with their cover letter to the address below. HP Enterprise Services Attn: Research Analyst PO Box 8036 Little Rock, AR 72203

62. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 62 HP Enterprise Services Provider Representatives Provider Representatives handle billing and policy issues that have been escalated from the Provider Assistance Center. They are also available to visit your office by appointment. Don’t know who your Provider Representative is? On the Medicaid website, click on “Meet your HP Enterprise Services Provider Rep” and then click on your county.

63. © Copyright 2014 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. 63 Questions?