Medical Billing Services in Arkansas

PRMS Billing Solutions provides complete billing and revenue cycle management for Arkansas providers, from Little Rock and Northwest Arkansas to Jonesboro, Fort Smith, and the Delta. Arkansas built a Medicaid model no one else uses: expansion adults carry commercial marketplace plans purchased by the state, while specialized populations run through PASSE care entities. We handle eligibility, coding, claims, denials, AR follow-up, and credentialing across this one-of-a-kind mix.

Medicare billing in Arkansas

Arkansas Part B claims are processed by Novitas Solutions, the Medicare Administrative Contractor for Jurisdiction H. We file to Novitas daily and screen against its local coverage determinations. Medicare Advantage in Arkansas features Humana, UnitedHealthcare, Arkansas Blue Cross's MA products, and WellCare, so MA enrollment is verified at eligibility before any Medicare claim goes out.

Arkansas Medicaid (ARHOME) billing

Arkansas expansion adults are covered through ARHOME, the private-option successor: the state buys them marketplace plans (largely Arkansas Blue Cross and Ambetter), so their claims bill like commercial claims with Medicaid rules underneath. Traditional Medicaid populations bill fee-for-service through the state MMIS, and behavioral/developmental populations run through PASSE entities (Summit Community Care and peers). Three lanes, three rulebooks. We identify the member's lane at eligibility and bill each correctly.

Commercial payers we bill in Arkansas

Arkansas Blue Cross and Blue Shield dominates the commercial market (with its USAble/Health Advantage affiliates), joined by Ambetter, QualChoice, UnitedHealthcare, and Cigna. Northwest Arkansas's corporate corridor (Walmart's orbit) adds large self-funded books administered by national TPAs, which we identify at eligibility so claims route to the right payer address every time.

Specialties we serve across Arkansas

We bill 25+ specialties across Arkansas, including its core fields: family medicine, internal medicine, cardiology, orthopedics, behavioral health (PASSE-routed where applicable), pain management, and urgent care.

Why Arkansas practices choose PRMS

Arkansas's recurring leaks: ARHOME members billed as ordinary Medicaid (or ordinary commercial) when their lane has its own rules, PASSE members' claims sent outside their care entity, and QualChoice/TPA books underworked. We sort lane, plan, and entity before the visit, then appeal wrongful denials and report weekly. Credentialing with Arkansas Medicaid, the PASSEs, and Arkansas Blue Cross is free for billing clients.

Related services

Explore our full medical billing & RCM services, denial management, and provider credentialing & payer enrollment (free for billing clients), or browse all 25+ specialties we bill and other states we serve.