Arkansas Medicaid in the Schools : Direct Billing

School districts and the rendering service providers must enroll as an Arkansas Medicaid provider prior to seeking Medicaid reimbursement for school-based services provided to students.

School-Based Medicaid Application Process

LEA or School District Medicaid provider applications must be submitted to the Division of Elementary and Secondary Education  (DESE) School Health Services office. The MITS staff will review and submit applications to the Arkansas Department of Human Services for processing. Once an LEA's  application has been processed, the LEA will receive a welcome letter via email from the DESE's MITS Office. The Medicaid provider applications are revalidated every five years.  

LEAs must submit Medicaid provider applications to the DESE School Health Services Office, ATTN: Sherri Pettit, sherri.pettit@Arkansas.gov 
 

Medicaid applications must be submitted per school-based service discipline area:

 
Districts acting as Medicaid providers of services assume sole responsibility for claims billed on behalf of the district. 
 
All performing providers must register for a National Provider Identification (NPI) number. The NPI is an unique identification number for covered health care providers. Once the NPI registration process has been completed, the LEA must use the Medicaid billing portal to link the NPI number to each Medicaid billing service area.
 

Parental Consent Requirements

FERPA, 34 CFR §99.30  (a) The parent or eligible student shall provide a signed and dated written consent before an educational agency or institution discloses personally identifiable information from the student's education records, except as provided in §99.31.

Special Education regulations require parental consent to release information for the purposes of Medicaid billing for Individual Education Plan (IEP) related services. Local Education Agencies (LEA)s should refrain from billing until the consent is signed by the parent.  Once signed, the consent is valid throughout the duration of the students enrollment in that district and will require parent notification annually.

Private Insurance

For students with coverage from a private insurance carrier in addition to Medicaid, Medicaid regulations require the district seek reimbursement of services through the private insurance carrier prior to claiming Medicaid reimbursement. If the private insurance claim is denied, the district may seek a claim denial letter from the private insurance carrier. The denial letter may be used as proof of seeking private insurance reimbursement for the purpose of seeking Medicaid reimbursement for services provided.

To download the MITS Program Advisor Regional Map in PDF format go to Regional Map.

For more information, please contact:

 
Dana Bennett, NorthWest Regional Program Advisor
Arkansas Department of Education
Division of Elementary and Secondary Education
School Health Services

Office: 479-495-1469

Rena McCone, Southern Regional Program Advisor
Arkansas Department of Education
Division of Elementary and Secondary Education
School Health Services
Office: 501-519-9279

Vacant, Northeast Regional Program Advisor
Arkansas Department of Education
Division of Elementary and Secondary Education
School Health Services

Office: 501-683-3604

Gina Babbitt, RN, Central Regional Program Advisor
Arkansas Department of Education
Division of Elementary and Secondary Education
School Health Services
Office: 501-683-3604