# Medical Billing Services in Arkansas | AR RCM Company | PRMS

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Medical Billing in Arkansas

# Medical Billing Services in Arkansas

Arkansas invented the "private option": Medicaid expansion through marketplace plans. Between ARHOME, PASSE, and Arkansas Blue Cross, AR billing has its own rulebook, and we know it.

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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](https://prmsbs.com/specialties/family-medicine-billing/), [internal medicine](https://prmsbs.com/specialties/internal-medicine-billing/), [cardiology](https://prmsbs.com/specialties/cardiology-medical-billing/), [orthopedics](https://prmsbs.com/specialties/orthopedic-medical-billing/), [behavioral health](https://prmsbs.com/specialties/behavioral-health-billing/) (PASSE-routed where applicable), [pain management](https://prmsbs.com/specialties/pain-management-medical-billing/), and [urgent care](https://prmsbs.com/specialties/urgent-care-billing/).

## 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**.

## Arkansas medical billing FAQs

**What is ARHOME and how does it change billing?

ARHOME is Arkansas's private-option Medicaid expansion: the state enrolls expansion adults in commercial marketplace plans (mostly Arkansas Blue Cross and Ambetter). Claims bill to those carriers, but Medicaid-side rules still apply underneath, so we treat ARHOME as its own lane.

**What is a PASSE?

A PASSE (Provider-led Arkansas Shared Savings Entity) manages care for members with complex behavioral health or developmental needs. Their claims must route through the member's PASSE, such as Summit Community Care, not ordinary Medicaid, and we verify that at eligibility.

**Which Medicare contractor covers Arkansas?

Novitas Solutions (Jurisdiction H) processes Arkansas Part B claims, with its local coverage determinations built into our scrubbing.

**Do you serve Northwest Arkansas practices?

Yes. Little Rock, NWA (Bentonville-Fayetteville), Jonesboro, Fort Smith, and the Delta, fully remote, inside your existing EHR or PM system.

## Related services

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

## See what your Arkansas practice is leaving on the table

Get a free, no-obligation revenue analysis. We measure your denial rate, days in AR, and recoverable revenue, specific to your payers.

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