Review.afmc.org
Medicaid Review and Prior Authorization Services AFMC
WebOur clinical Services team, which consists of physicians and registered nurses, conducts more than 185,000 medical case reviews per year. These include prior authorizations and retrospective utilization reviews to ensure that all health care services reimbursed by our clients are provided in the most efficient manner and are medically necessary.
Actived: 9 days ago
Medicaid Extension of Benefits Review Services AFMC
WebIf submitted via carrier service, please use AFMC 1101 S. 21st St., Fort Smith, AR, 72901. Requests for extension of benefits are considered only after a claim is filed and is denied because the patient’s benefit limits are exhausted. Submit with the request a copy of the Medical Assistance Remittance and Status Report reflecting the claim
Medicaid Utilization Management Program Review Services
WebRecords can be directly attached to the request. Arkansas Medicaid Provider Portal. AFMC/MMIS Outreach Specialist Information Sheet. AFMC pre-certification: Call 800-426-2234. AFMC Clinical Services phone review hours: 8:00 a.m.-12:00 p.m. and 1:00 p.m.-4:30 p.m. Monday through Friday, except for holidays.
Arkansas Medicaid Hyperalimentation Program Review Services
WebThe request for preapproval can be submitted through the Arkansas Medicaid Healthcare Provider Portal. After a preapproval has been submitted through the portal, the provider may call the AFMC Clinical Services Department at 479-649-8501, option 1 or email [email protected] to notify us that a preapproval has been submitted.
Emergency Room Retrospective Review Process AFMC
WebMedicaid Provider Fair Hearing requests must be sent to Arkansas Department of Health, Medicaid Provider Appeals Office, 4815 West Markham Street – Slot 31, Little Rock, AR 72205. Contact us. If you have further questions on specific reviews, please email us at This email address is being protected from spambots.
Retrospective Review Services Medicaid Hospital Stays AFMC
WebContact us. If you have further questions on specific reviews, please email us at [email protected] or contact AFMC’s Clinical Services Department at 479-649-8501, option 1.
Prosthetics Prior Authorization Review Services AFMC
WebContact us. If you have further questions on specific reviews, please email us at [email protected] or contact AFMC’s Clinical Services Department at 479-649-8501, option 1.
Medicaid Fairness Act Review Services AFMC
WebArkansas Department of Health. Medicaid Provider Appeals Office. 4815 W. Markham St., Slot 31. Little Rock, AR 72205. The provider may appear in person, through a corporate representative or, with prior notice to the department, through legal counsel. A Medicaid recipient may attend any hearing related to his or her care, but the recipient’s
Physician Reviewers Arkansas Medicaid Peer Review Services
WebPhysician Reviewers. AFMC is expanding its Arkansas Medicaid peer review services, and we need your expertise. We’re looking for periodic physician reviewers in all specialties, especially cardiovascular surgery, psychology, orthopedics and oncology/hematology. Work at home on your own schedule and help make Arkansas’ health care system the
Assistant Surgeon Prior Authorization Review Services AFMC
WebAFMC precertification phone number: 800-426-2234. AFMC clinical services phone hours: 8:00 a.m.-12 p.m. and 1:00 p.m.-4:30 p.m. Monday through Friday, except for holidays. All calls are monitored for quality assurance purposes. When calling AFMC to obtain authorization for an assistant surgeon, the following information will be required:
Transparency in Coverage
WebTransparency in Coverage: Machine-Readable Files . This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers.
AFMC CODE OF CONDUCT
WebAFMC is a leading quality improvement organization committed to improving health care throughout the state and nation. We are dedicated to educating Arkansans about their health and helping them get the care they need. In our efforts, we maintain superior ethics, business practices and corporate responsibility.
Hyperalimentation Section II
Web222.400 Fair Hearing Requests 10-1-06 The Medicaid beneficiary may request a fair hearing of an adverse review determination from the Department of Health and Human Services (DHHS). The appeal request must be in writing and sent to the Appeals and Hearings Section of DHHS within thirty-five calendar days of the date on the denial letter.
Section I All Provider Manuals
Web1. Applicants whose health insurance is inaccessible are deemed uninsured. 2. Children who do not have primary comprehensive health insurance, whose insurance is inaccessible or have non-employer sponsored insurance are considered uninsured. Primary comprehensive health insurance is defined as insurance that covers both physician and …
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