Medical Billing Services in Arkansas
Arkansas Medicaid runs on two tracks, and billing to the wrong one is a guaranteed denial. Most Medicaid claims go fee-for-service to the state, but members with complex behavioral health or intellectual and developmental disability needs are served through a separate managed care program with its own plans, networks, and billing rules. A practice that treats both populations has to sort every patient into the right track before the claim goes out.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for Arkansas practices of every specialty, built around the state’s actual payers and programs.
Arkansas’s payer landscape
Most Arkansas Medicaid services are billed fee-for-service to the state. Managed care is used narrowly, through the Provider-Led Arkansas Shared Savings Entity (PASSE) program, which serves Medicaid beneficiaries with a high level of need related to behavioral health diagnoses or intellectual and developmental disabilities. Four PASSE organizations operate in the state: Arkansas Total Care, CareSource PASSE, Empower Healthcare Solutions, and Summit Community Care. Each PASSE has its own network, provider manual, and billing process, and claims for PASSE members must go to the PASSE organization, not to fee-for-service Medicaid. The state’s expansion coverage, ARHOME, runs through premium assistance in marketplace plans, which adds a third billing path for expansion adults.
Commercial coverage is led by Arkansas Blue Cross Blue Shield, through Health Advantage and USAble Mutual, alongside QualChoice, UnitedHealthcare, and Ambetter. Medicare Advantage prior authorization affects a share of schedules in the Little Rock and Northwest Arkansas metros.
What MedPlus RCM handles for Arkansas practices
- End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing. That is the full cycle.
- Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
- Provider credentialing and enrollment. End-to-end enrollment with Arkansas Medicaid, PASSE organizations, commercial payers, and Medicare, plus re-credentialing maintenance.
- Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
- A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
- Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
We serve practices statewide, Little Rock, Fayetteville, Fort Smith, Jonesboro, and Springdale, across specialties including primary care, mental and behavioral health, cardiology, orthopedics, dermatology, and physical therapy.
Results Arkansas practices can check
MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.
Frequently asked questions
Why is Arkansas Medicaid billing tricky?
Arkansas has two Medicaid tracks. Most claims go fee-for-service, but PASSE members must be billed through their PASSE organization. Sending a PASSE claim to fee-for-service Medicaid, or the reverse, produces a denial that has nothing to do with the care provided.
Do you work with Arkansas PASSE plans?
Yes. We bill all four PASSE organizations, Arkansas Total Care, CareSource PASSE, Empower Healthcare Solutions, and Summit Community Care, as well as fee-for-service Arkansas Medicaid, ARHOME plans, commercial payers, and Medicare.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.
Get a free financial audit
Find out where your Arkansas practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
