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 That address only works for fee-for-service claims on an original CMS-1500 or UB-04 form. Crossover claims for dual Medicare/Medicaid beneficiaries use a different P.O. Box, and claims for anyone enrolled in a PASSE managed-care plan skip Gainwell entirely and go to the plan.
Pick the Right Address First
Three scenarios, three destinations. Confirm the beneficiary’s coverage before you print the envelope.
Standard Fee-for-Service Claims
Professional (CMS-1500) and institutional (UB-04) claims for fee-for-service Medicaid beneficiaries go to:2Arkansas Foundation for Medical Care. New Provider Workshop Presentation
Gainwell Technologies
Attn: Claims
P.O. Box 8034
Little Rock, AR 72203
Medicare Crossover Claims
If the patient has both Medicare and Medicaid, the Medicaid portion of the crossover claim goes to a separate box:1Arkansas Department of Human Services. Frequently Asked Questions for Providers
Gainwell Technologies
P.O. Box 34440
Little Rock, AR 72203
PASSE Managed-Care Claims
Beneficiaries in a Provider-led Arkansas Shared Savings Entity (PASSE) plan receive services through that plan, and claims go directly to the PASSE. A PASSE claim sent to P.O. Box 8034 will be denied. Verify enrollment before filing, then mail to: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 sets its own billing rules and electronic submission process.
Use the Right Paper
Gainwell only accepts original red-ink, sensor-coded claim forms. Photocopies and black-and-white printouts are rejected on arrival, even when mailed to the correct P.O. Box.1Arkansas Department of Human Services. Frequently Asked Questions for Providers Paper is slower and more error-prone than electronic filing, so treat it as a fallback when EDI through the Arkansas Medicaid Provider Portal is not available.
The 12-Month Filing Deadline
A correctly addressed claim still fails if it arrives too late. Arkansas Medicaid enforces a 365-day filing deadline measured from the date of service, with no exceptions.4Arkansas Department of Human Services. Timely Filing Quick Training Guide The same 12-month window applies to initial claims, resubmissions, adjustments, and crossover claims.5Cornell Law Institute. 016.06.17 Arkansas Code R. 024 – SecIII-2-17 Billing If you discover an error on a previously paid claim, the adjustment must still land within 365 days of the original date of service, not from the date you found the problem.6Code of Arkansas Rules. Section III All Provider Manuals A claim filed one day late is denied, and the deadline cannot be appealed.
After You Mail the Claim
Claim status for both paper and electronic submissions is available through the Arkansas Medicaid Provider Portal.7Arkansas.gov. Arkansas Provider Portal Home For status checks by phone, or for help with billing, enrollment, or technical issues, contact the Provider Assistance Center (PAC):8Arkansas 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
- PAC mailing address: Gainwell Technologies, Provider Assistance Center, P.O. Box 8036, Little Rock, AR 72203-8036
If the Claim Is Denied
Denied claims have two levels of review. Start with an administrative reconsideration, which must be requested in writing within 30 calendar days of the notice of adverse action; the clock starts five days after the date on the notice.9Arkansas Department of Human Services. Medicaid Administrative Reconsiderations and Appeals Send the request to whichever entity issued the adverse decision, with the notice and any supporting documentation attached. If reconsideration upholds the denial, you have 10 calendar days from receipt of that decision to request a formal fair hearing.
Fair hearing requests do not go to DHS or Gainwell. They go to the Arkansas Department of Health:10Arkansas Department of Health. Medicaid Provider Appeals
Medicaid Provider Appeals
Arkansas Department of Health
4815 West Markham Street – Slot 31
Little Rock, AR 72205
The fair hearing request must be submitted within 30 calendar days of the date on the notice of adverse action. Miss that deadline and the right to a hearing is waived.