Provider Resources
Coronavirus (COVID-19)
We are currently experiencing some issues and long wait times with our Teledoc and Referral lines. Please be patient with us as we work through this busy period.
To receive the fastest response on referrals, please submit authorization requests through our provider portal or via fax at: 1-833-632-6934
COVID-19 Resources:
- COVID-19 In-Home Care Guidance (PDF)
- CES Waiver Emergency Request Form (PDF)
- COVID-19 Extended Coverage Announcement (PDF)
- Supplemental Support Service (PDF)
Arkansas Total Care provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2023 Provider Manual (PDF)
- 2022 Provider Manual (PDF)
- 2021 Provider Manual (PDF)
- 2019 Provider Manual (PDF)
- Quick Reference Guide (PDF)
- Payspan (PDF)
- Secure Portal (PDF)
- Provider Education Member ID Card (PDF)
- How to Check Eligibility (PDF)
- ICF Billing Instructions (PDF)
- Incident Report (PDF)
- How to Use Secure Messaging (PDF)
- Codes Modifiers and Rates (PDF)
- Provider Waiver Manual (PDF)
- Provider Waiver Manual (PDF) RETIRED
- Lab Compensation Schedule (PDF)
- DME Compensation Schedule (PDF)
- Negative Balance How To Guide (PDF)
- ICF Member Responsibility Claims Processing Update (PDF)
- New Individual & Family Therapy Billing Guidance (PDF)
- First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP) (PDF)
- Long-Acting Medications as First-Line Treatment in Schizophrenia (PDF)
- Supportive Living Criteria (PDF)
- Supportive Living Provider Level 2 & Level 5 Rate Request Form (PDF)
- Supportive Living Physician/Clinician Recommendation for Level 2 & Level 5 Rates Form (PDF)
Provider Newsletter
- Provider Newsletter - Spring 2022 (PDF)
- Provider Newsletter — Fall 2021 (PDF)
- Provider Newsletter — Spring 2021 (PDF)
- Provider Newsletter — Q2 2019 (PDF)
- Provider Newsletter — Q1 2019 (PDF)
Medical Management
- Pre-Auth Needed?
- Prior Authorization 2019 Guidelines (PDF)
- How To Secure Prior Authorization (PDF)
- How To Submit Prior Authorization (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Behavioral Health PA Guidelines (PDF)
- Waiver Treatment Plan Template Fillable Form (PDF)
- CES Waiver Emergency Request Form (PDF)
- Waiver Services Authorization Form (PDF)
- POA Inpatient Requirements (PDF)
- Permission for Property Modification Letter (PDF)
Claims and Claim Payment
Provider Credentialing
Attention: If you would like to become a provider within our network, please fill out the Become A Provider form. Or call us at 1-866-282-6280 or TTY: 711.
- Allied- and Advance-Practice Nurse Credentialing Application (PDF)
- Medical Doctor or Doctor of Osteopathy Credentialing Application (PDF)
- Atypical and Non-licensed Practitioners Roster Template
- Arkansas State Medical Board Attestation Form 2020 (PDF)
This form must be returned with your MD/DO Credentialing Application (PDF) in order to complete your submission. - Arkansas Total Care Atypical & HCBS Provider Application (PDF)
- Provider Data Change Form (PDF)
HEDIS Tips and Quick Guides
- Reducing the Stigma: Mental Illness (PDF)
- Assess, Educate, and Treat Patients with Depression (PDF)
- Medications for Opioid Use Disorder (MOUD) — Buprenorphine (PDF)
- Opioid Overdose Prevention (PDF)
- Safer Prescribing for Pain Management and Opioids (PDF)
- Substance-Related Use Disorder (PDF)
- Early and Periodic Screening, Diagnosis, and Treatment Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) (PDF)