News for Current Providers
BreastCare Patient Eligibility Verification (September 2017)
Eligibility verification for BreastCare patients is no longer available through the Medicaid portal. This service ended August 31, 2017. BreastCare providers can verify eligibility from the plan dates on the patient’s BreastCare card or by contacting BreastCare at 1-855-661-7830.
Provider Re-enrollment Reminder (September 2017)
Providers who have not submitted their renewal agreements for the 2017-2019 agreement period are encouraged to do so as soon as possible. Only current providers with 2017-2019 agreements have access to submit claims through our new BreastCare Billing System.
BreastCare Billing System Launched (September 2017)
Our new web-based BreastCare Billing System was launched in early September. Billing personnel who need access and have not already requested it, should complete and return the form below. Only BreastCare providers with current agreements can access the system. If your provider group(s) does not have a current agreement or have not yet completed the re-enrollment process, you are encouraged to do so soon.
BreastCare Billing Transitioning
Recently, you may have received a notice that the billing and claims management process for the Arkansas Department of Health’s BreastCare program will transition from DXC Technology to the Arkansas Department of Health (ADH) effective September 1, 2017. As a valued BreastCare provider, we want to assure you that BreastCare is not being discontinued and that we will continue offering screening and diagnostic services through our provider network. However, ADH will manage BreastCare billing and claims through a new ADH web-based system that will allow you to submit claims directly to BreastCare.
Initially, you will only be able to use this web-based application to submit claims, similar to what some providers currently do using PES or DDE. For quicker processing, the new BreastCare Billing System will run all edits at the time the claim is entered and notify the user of any issues so they can be corrected immediately, thereby eliminating denials that have to be worked and resubmitted. Once the claim is accepted, you know it will be processed for payment.
If you use a vendor system, such as Emdeon, Zotec Solutions or similar in-house designed system, to submit your claims, you will need to contact BreastCare to coordinate a new process. While electronic claims submission is preferred for faster processing, BreastCare will still accept paper claims mailed to the address below. Providers will continue to receive payment through an electronic funds transfer process and remittance advice notices.
Important dates for providers include:
- Paper claim submission to DXC ends August 11, 2017
- Electronic claim submission to DXC through PES, DDE and vendor systems ends August 25, 2017 at 11:59 PM (Submit any outstanding claims by this date)
- Final remittances will be distributed by DXC on August 31, 2017
- DXC call center operations will end at 4:30 PM on August 31, 2017
- Remittance advices will be available from DXC until September 28, 2017
We appreciate your service as a BreastCare provider and look forward to our continued partnership offering high quality breast and cervical screening and diagnostic services to the women of Arkansas.
Questions or concerns regarding this transition can be directed to BreastCare via e-mail at BreastCare@arkansas.gov or the mailing address below.
Arkansas Department of Health
Attn: BreastCare Billing
4815 West Markham Street, Slot 11
Little Rock, AR 72205
Breast and Cervical Reimbursement Rates Updated for 2017 (March 2017)
BreastCare has updated the reimbursement amounts for covered procedures for 2017. The updated reimbursement rate tables can be found under Billing Information on the Forms and Manuals page.
BreastCare Now Covers 3D Mammography (January 2017)
The Arkansas BreastCare program is now covering 3D mammography (tomosynthesis) as a reimbursable procedure as of October 1, 2016. BreastCare is using the following CMS guidance for Medicare reimbursement instructions for billing these codes:
- 77063 should be listed as a separate code in addition to the code for the primary mammogram code, 77057 or G0202. Do not report this code with 77055 or 77056.
- G0279 should be listed as a separate code in addition to G0204 or G0206 for the primary mammogram.
- The codes 77061 and 77062 are not allowed as they are not approved by Medicare.
The BreastCare program has revised eligibility guidelines to expand coverage. The revised guidelines include expanding the age range for cervical cancer screening and diagnostic services and providing diagnostic services for underinsured (insured but meet financial criteria) women who qualify. BreastCare now covers Pap testing for uninsured women between 21 and 39 years old as well as any diagnostics and follow up needed as a result of an abnormal screening. Diagnostic services may also be covered for those who are insured but need assistance with co-pays, co-insurance or deductibles. For questions about these new guidelines, please contact your Regional BreastCare Coordinator. (March 2016)
Becoming a BreastCare Provider
Regular screening and early detection are our best bets for helping Arkansas women fight breast and cervical cancer. We always welcome the opportunity to partner with more providers to offer breast and cervical services.
It is easy to enroll! Just go to https://health.arkansas.gov/BreastCareOnlineNew/ and complete your online application. It only takes about 15 minutes to complete a basic application.
In order to enroll as a BreastCare provider you will need to complete: Provider Basic Identification, Provider Demography, Provider Banking Information, W-9 Form, Provider Specialty Form, and Questionnaire. Have all documents for the application ready and the process will move faster.
For questions or additional information, contact our Provider and Contracts Manager at 501-661-2836.