Credentialing in Arkansas

PASSE enrollment is acuity-triggered, e.g., a member who "Has a Behavioral Health (BH) diagnosis and needs services in addition to counseling and medication management," or an active Independent Assessment at Tier 2 or higher ("To qualify for PASSE enrollment, individuals must be assessed as Tier 2 or higher"). Routine counseling-level members stay fee-for-service under the Counseling & Crisis Services program, so one BH caseload can need both the state enrollment and the PASSE contracts.

Arkansas DHS, PASSE program page · checked Jul 2026

Arkansas Medicaid is run by the DHS Division of Medical Services (DMS); provider enrollment goes through the Arkansas Medicaid Provider Portal (portal.mmis.arkansas.gov, a Gainwell MMIS), Provider Enrollment: (501) 376-2211 / (800) 457-4454. Enrollment with the state comes first; PASSE credentialing sits on top.

Arkansas Medicaid Provider Portal (Gainwell MMIS) · checked Jul 2026

Arkansas runs a three-lane structure with no conventional statewide MCO. The nationally unique PASSE model (Provider-led Arkansas Shared Savings Entity) uses provider-led risk entities to manage "individuals with complex behavioral health needs and intellectual or developmental disabilities". The four PASSEs are Arkansas Total Care, CareSource PASSE, Empower Healthcare Solutions, and Summit Community Care, and "The PASSE will provide most physical health, behavioral health, and specialized developmental disability services for all beneficiaries enrolled as members in their PASSE." Everyone outside PASSE and ARHOME is fee-for-service through the Gainwell MMIS.

Arkansas DHS, PASSE program page · checked Jul 2026

Ark. Code Ann. § 23-99-411 requires a credentialing decision within "Sixty (60) calendar days" of a completed application for physicians and "One hundred eighty (180) calendar days" for "any other provider," with written acknowledgment in 10 days; if no incompleteness notice goes out within 15 days "the application shall be deemed complete." Teeth apply to physicians only: "a fine of one thousand dollars ($1,000) per day shall be imposed for each day exceeding the sixty (60) days."

Ark. Code Ann. § 23-99-411 (FindLaw republication) · checked Jul 2026

"Non-independently licensed clinicians must serve as a rendering provider through a certified agency provider", Arkansas's non-independent tier (LMSW, LAC, LAMFT, LPE, PLP, PLMSW) must be employed or contracted by a certified Behavioral Health Agency, Community Support System Agency, or a Dept. of Education-certified school-based mental health provider, with supervision required. The associate still goes on the claim: the CMS-1500 rendering-provider field takes the "NPI of the individual who furnished the services billed for in the detail." "Independently licensed practitioners (ILPs) can enroll directly as an Independently Licensed Practitioner without certification" (LCSW, LMFT, LP, LPEI, LPC, LADAC).

Arkansas Medicaid Counseling and Crisis Services Provider Manual Section II (via Wayback) · checked Jul 2026

Arkansas IS a Counseling Compact member (on the counselingcompact.gov jurisdictions list) but NOT yet issuing compact privileges as of July 2026 (issuers so far: AZ, MN, OH, LA, GA, IN).

Counseling Compact, Compact Jurisdictions list · checked Jul 2026

The Arkansas Board of Examiners in Counseling (ABEC) licenses LAC advancing to LPC, and LAMFT advancing to LMFT; associates practice under a board-approved supervision plan.

UA Little Rock, LPC process (ABEC overview, secondary) · checked Jul 2026

ARHOME (which replaced Arkansas Works on 2022-01-01) "uses Medicaid dollars to buy private health insurance", qualified health plans from Arkansas Blue Cross Blue Shield or Ambetter, so commercial-side credentialing applies for the expansion-adult population.

Arkansas DHS, ARHOME page · checked Jul 2026

"All PASSE providers must be enrolled as a Medicaid provider first." Then: "PASSE providers must enroll separately with each PASSE organization they want to contract with. PASSE members are not enrolled by geographic area, but by a rotation (or personal preference)". So a provider's panel is only whole with all four PASSE contracts. Also: "All Medicaid claims must be submitted within 365 days of the date of service."

Arkansas DHS, For PASSE Providers · checked Jul 2026

Physician primary-source verification runs through the Arkansas State Medical Board Centralized Credentials Verification Service (ASMB-CCVS), a state-mandated CVO under Ark. Code Ann. § 17-95-107; the 60-day prompt-credentialing clock is tolled while the CCVS file is being built.

UHC Credentialing Plan State & Federal Regulatory Addendum (rev. 4/2026) · checked Jul 2026

Under Ark. Code Ann. § 23-99-411(a)(6), "a healthcare insurer shall treat an applicant physician as a participating physician from the date of submission of a completed application once an applicant physician has been approved." This retro lever is physician-scoped. It does not extend to LPC/LCSW or other non-physician providers.

Ark. Code Ann. § 23-99-411 (FindLaw republication) · checked Jul 2026