Arkansas Provider Enrollment – Frequently Asked Questions

Note: The information provided within this FAQ page is according to the state, unless otherwise indicated (e.g., some areas indicate “According to CMS/Medicaid”).

For full information regarding Provider Medicaid Enrollment in Arkansas, please visit the Arkansas Medicaid Provider Enrollment page.

General Questions

Who is required to enroll in the state Medicaid program?

  • Individuals
  • Groups

I am enrolled as a participating provider in another state’s Medicaid program. Do I also need to enroll in Arkansas’ Medicaid Program to provide services to Medicaid beneficiaries?

Yes, any provider of healthcare services must be enrolled in the Arkansas Medicaid Program before Medicaid will cover any services provided to Arkansas Medicaid beneficiaries.

How do I enroll?

Navigate to the Arkansas Medicaid Provider Portal to complete an online enrollment application. Paper applications and additional information can also be found on the portal.

How does my registration relate to billing for services?

You must register with the state using the same identifiers (e.g., TIN/SSN, specialty) you plan to use for billing.

The following items must be in alignment:

  • Your contract with Envolve / Centene Dental and Vision
  • State Registration
  • Billing Setup / Configuration

Screening and Risk Level Requirements

Are there additional requirements or screenings based on risk level?

According to CMS/Medicaid:

Requirements by Risk Level:

  • All Risk Levels:
    • Verify provider meets any applicable Federal regulations or State requirements for the provider type prior to making an enrollment decision.
    • License verifications.
    • Conduct database checks.
  • Limited Risks: Site visit.
  • High Risks:
    • Any provider with a payment suspension based on a credible allegation of fraud within the last 10 years.
    • Providers excluded within the past 10 years by HHS-OIG or a State Medicaid Agency (SMA).
    • Providers with a qualifying Medicaid overpayment.
    • Providers enrolling within 6 months of a lifted temporary moratorium that previously barred enrollment.

States may impose additional screening methods “in addition to or more stringent than” those in the regulations. This could result in a change in the risk category assigned for certain providers. Check with your SMA to determine your risk category.

Additional details can be found on the Arkansas Medicaid site under “Division of Medical Services Provider Enrollment.”

Enrollment Timeline

What is the enrollment application processing timeframe?

This information is not provided by the state.

What is my Enrollment Effective Date, and how is it determined?

This information is not provided by the state.

How do I find proof of registration?

This information is not provided by the state.

Revalidation and Updates

I received a letter from the State requesting re-enrollment, re-registration, or revalidation. What do I do?

Log in to the Arkansas Medicaid Portal and complete the revalidation application. Federal regulations require the state to regularly review your information and screening.

How often do I need to re-enroll, re-register, or revalidate my information?

According to the state, Federal regulation requires Arkansas Medicaid to revalidate the enrollment of all providers at least every five (5) years.

A revalidation notice will be sent 90 days before the deadline using the “Mail To” address on file.

Important: Keep your address updated to ensure receipt of notices. Failure to submit required documentation before the deadline may interrupt claims processing.

Issues with Registration Status

I received a letter from Envolve / Centene Dental and Vision Services about my registration status. What do I do?

Your state provides regular updates on provider registration statuses. If your registration is inactive:

  • Validate your state registration status and confirm whether any outstanding items need resolution.
  • If you have proof of valid registration, contact us.

Contact Information

Who do I contact if I have questions about my enrollment or registration?

If any of my information changes, what should I do?

Keep your information up to date! Notify us and update your details via the state portal. Ensure the following details are current:

  • Office Address (including suite number)
  • Office Hours
  • Mailing Address
  • Phone Number

Check the information Envolve / Centene Dental and Vision has for you using the “Find A Provider” tool on our website. Report any discrepancies or updates promptly.

Keeping your information current ensures proper claim processing and member satisfaction.