Provider Resources

Arkansas Total Care provides the tools and support you need to deliver the best quality of care.

Reference Materials

• Provider Newsletter - Q1 2019 (PDF)
• 2019 Provider Manual (PDF)
• Quick Reference Guide (PDF)
• Payspan (PDF)
• Secure Portal (PDF)
• Provider Education Member ID Card (PDF)
• Prior Authorization Guide (PDF)
• Incident Report (PDF)

Medical Management

• Pre-Auth Needed?
• Inpatient Prior Authorization Fax Form (PDF)
• Outpatient Prior Authorization Fax Form (PDF)

Claims and Claim Payment

• Electronic Transactions (PDF)
• Claim Dispute Form (PDF)
• Health Care Claim: Professional (837) (PDF)
• Health Care Claim: Institutional (837) (PDF)

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 TDD/TTY: 711.

• Credentialing Atypical Provider Application (PDF) - Coming soon
• Allied and Advance Practice Nurse Credentialing Application (PDF)
• Medical Doctor or Doctor of Osteopathy Credentialing Application (PDF)