The mailing address for standard Arkansas Medicaid paper claims is Gainwell Technologies, Attn: Claims, P.O. Box 8034, Little Rock, AR 72203.1Arkansas Department of Human Services. Frequently Asked Questions for Providers Gainwell is the state’s fiscal agent and handles fee-for-service claims processing for the Arkansas Department of Human Services. Two situations use a different address: Medicare/Medicaid crossover claims go to a separate P.O. Box, and claims for beneficiaries enrolled in a PASSE managed-care plan go directly to the plan and never touch Gainwell. Sending a claim to the wrong address means a return or a denial, so verify which category your claim falls into before you drop it in the mail.
Standard Paper Claim Address
Paper claims filed on the CMS-1500 (professional) or UB-04 (institutional) form go to:2Arkansas Foundation for Medical Care. New Provider Workshop Presentation
Gainwell Technologies
Attn: Claims
P.O. Box 8034
Little Rock, AR 72203
Only original red-ink, sensor-coded claim forms are accepted. Photocopies and black-and-white printouts will be rejected.1Arkansas Department of Human Services. Frequently Asked Questions for Providers
Crossover Claims for Dual-Eligible Beneficiaries
Claims for beneficiaries covered by both Medicare and Medicaid use a different P.O. Box:1Arkansas Department of Human Services. Frequently Asked Questions for Providers
Gainwell Technologies
P.O. Box 34440
Little Rock, AR 72203
PASSE Beneficiaries: Bill the Plan, Not Gainwell
If the patient is enrolled in a Provider-led Arkansas Shared Savings Entity (PASSE) managed-care plan, the claim goes to that plan, not to Gainwell. A PASSE claim sent to P.O. Box 8034 will be denied. Verify the patient’s enrollment status before filing. The current PASSE organizations and their contact addresses are:3Arkansas Department of Human Services. PASSE Contact Us
- Arkansas Total Care — P.O. Box 25010, Little Rock, AR 72221
- CareSource — 425 W. Capitol Avenue, Suite 3000, Little Rock, AR 72201
- Empower Healthcare Solutions — 17500 Chenal Pkwy., Suite 300, Little Rock, AR 72223
- Summit Community Care — 650 Shackleford Rd. #440, Little Rock, AR 72211
Each PASSE has its own billing requirements and electronic submission process.
Twelve-Month Filing Deadline
Every claim must be submitted within 365 days of the date of service.4Arkansas Department of Human Services. Timely Filing Quick Training Guide The deadline applies equally to initial claims, adjustments, resubmissions, and crossover claims for dual-eligible beneficiaries.5Cornell Law Institute. 016.06.17 Arkansas Code R. 024 – SecIII-2-17 Billing A claim filed one day past the 12-month mark will be denied, and no appeal overrides the deadline.
If a paid claim needs correction, the adjustment must be submitted within that same 12-month window from the original date of service, not from the date the problem was discovered.6Code of Arkansas Rules. Section III All Provider Manuals Paper claims travel and log in more slowly than electronic ones, so leave a cushion.
Electronic Submission Is Faster
Electronic Data Interchange is the preferred submission method and significantly faster than paper. Before transmitting, a provider must enroll as a Trading Partner through the Arkansas Medicaid Provider Portal and receive a Trading Partner ID, which functions as the Electronic Submitter ID.7Arkansas Department of Human Services. Health Care Portal Job Aid – FAQ for Trading Partners Enrollment Providers using a clearinghouse or billing company complete a separate portal registration step after receiving the ID.8Arkansas Department of Human Services. Health Care Portal Job Aid – Registering on the Portal, Trading Partners
Claims transmit as HIPAA-standard transaction sets: 837P for professional, 837I for institutional, and 837D for dental. Providers can also enroll to receive the 835 Electronic Remittance Advice for electronic payment details.7Arkansas Department of Human Services. Health Care Portal Job Aid – FAQ for Trading Partners Enrollment Confirm the Arkansas Medicaid Payor ID through the portal or your clearinghouse before you send anything.
Checking Status and Getting Help
Claim status is available through the Arkansas Medicaid Provider Portal for both electronic and paper submissions.9Arkansas.gov. Arkansas Provider Portal Home For questions about claim status, enrollment, billing, or technical issues, the Provider Assistance Center (PAC) at Gainwell handles calls and written inquiries:10Arkansas Department of Human Services. Provider Assistance Center Information
- Toll-free in Arkansas: (800) 457-4454
- Local or out of state: (501) 376-2211
- Hours: 8:00 a.m. to 5:00 p.m., Monday through Friday, excluding state holidays
- Mailing address: Gainwell Technologies, Provider Assistance Center, P.O. Box 8036, Little Rock, AR 72203-8036
General administrative correspondence with the Division of Medical Services goes to a different address:11Arkansas.gov. Contact Us
Arkansas Division of Medical Services
Department of Human Services
P.O. Box 1437, Slot 5401
Little Rock, Arkansas 72203-1437