Frequently Asked Questions 

FAQs: Patient Management | Provider Management | Billing and System 

Provider Management

How do I become a BreastCare Provider?

Access https://health.arkansas.gov/BreastCareOnlineNew/ and follow the instructions to become a BreastCare Provider or while at the BreastCare website (www.ARBreastCare.com) click on Just for Providers, and then Provider Enrollment.

Where do I find BreastCare Provider Management forms?

Access this link to find the forms http://www.healthy.arkansas.gov/programsServices/chronicDisease/ArBreastCare/Pages/ProviderNewInfo.aspx.  They are also on the BreastCare website under Just for Providers, and then click on Forms & Manuals.

How do I add a provider to my group’s BreastCare PHSA?

Complete the Provider Name and Specialty Form.

  • Enter Provider BreastCare Number, Provider Name, A (for add), effective date (to ensure dates are correct for billing) Individual Social Security Number (if applicable), Individual National Provider Identifier (NPI) Number, Specialty, PCP/Colposcopy/Both, Medicare Number (BreastCare uses this number for validation), Medical or Nurse License and Drug Enforcement Administration (DEA) Registration (if applicable)
  • Submit the completed form along with copies of the current medical/nursing licenses and DEA registration, if applicable via fax 501-661-2189or email to Shiela.Couch@arkansas.gov or Wanda.Lungaho@arkansas.gov

How do I delete a provider from my group’s BreastCare PHSA?

Complete the Provider Name and Specialty Form.

  • Enter Provider BreastCare Number, Provider Name, D (for delete), effective date (to ensure dates are correct for billing) Individual Social Security Number (if applicable), Individual National Provider Identifier (NPI) Number, Specialty, PCP/Colposcopy/Both, Medicare Number (BreastCare uses this number for validation), Medical or Nurse License and Drug Enforcement Administration (DEA) Registration (if applicable)
  • Submit the completed form along with copies of the current medical/nursing licenses and DEA registration, if applicable via fax 501-661-2189 or email to Shiela.Couch@arkansas.gov or Wanda.Lungaho@arkansas.gov

How do I change my provider name, tax identification number, or national provider identifier (NPI) number?

Complete the Provider Information Change Form and mail it to BreastCare (4815 West Markham, Slot 11, Little Rock, AR 72205) with supporting document(s), i.e. updated W-9. If NPI change, then you must go to https://www.medicaid.state.ar.us/ to link your new NPI number to BreastCare.  

How do I change my banking information?

Complete the Authorization for Automatic Deposit Form and email it with a bank account verification letter or a voided check to shiela.couch@arkansas.gov or wanda.lungaho@arkansas.gov

When and how should I notify BreastCare of provider agreement contact persons change?

Complete the Provider Information Change Form to inform BreastCare of any changes made regarding your agreement, such as contact person’s name, telephone number and/or email address. Fax this information to 501-661-2189 or email this form to shiela.couch@arkansas.gov and or wanda.lungaho@arkansas.gov.  This is vital to our communication with your group.