Provider Enrollment Revalidation Webinar · Courtney Tipple, DXC Eyvonne Carbage-McCartney, DXC...
Transcript of Provider Enrollment Revalidation Webinar · Courtney Tipple, DXC Eyvonne Carbage-McCartney, DXC...
Provider Enrollment Revalidation WebinarPresented by:Karen Young, AFMCCourtney Tipple, DXCEyvonne Carbage-McCartney, DXCAudrey Orange, DXC
November 8, 2018
AgendaTools and Resources for Provider Application
Video on how to complete online application
Required Documentation Guide
Arkansas Medicaid Provider Portal application instructions
Enrollment FAQs
Printable Enrollment-Related Forms
Live Demo
Things to Know
Contact InformationNote: Please refer to www.Medicaid.mmis.arkansas.org to access Provider Enrollment tools and resources
Arkansas Medicaid website:www.medicaid.mmis.arkansas.gov
Live Demo-HealthCare Provider Portal –https://portal.mmis.arkansas.gov/ARMedicaid/Provider
Things to Know
Scan documents/attachments before you start filling out application(Licenses,
certifications, EFT forms, voided checks, IRS letter, etc.)
Individual applications-ONLY the individual can sign application
Individual’s application can ONLY reflect the W9 of the individual’s information
Linking to a Group-The paper version of Section 4 must be printed, signed and
uploaded with the attachments
EFT Form must be completed for the enrolling provider ONLY
Provider Enrollment cannot accept direct deposit sign up forms from Bank Websites,
CMS Website or any other State Agency. ONLY Arkansas Medicaid Website
ALL new providers must have an EFT on file or their application will not be approved–
11/1/2018 Copyright © 2017 AFMC, Inc. All Rights Reserved.
DXC TechnologyProvider Enrollment Contact information
Monday through Friday (8 a.m.–5 p.m.)
• Toll-free in Arkansas: 800-457-4454 (Option 3)
• Local or out-of-state: 501-376-2211
• Dedicated fax: 501-374-0746
DXC Technology
PO Box 8105
Little Rock, AR 72203-8105