Prior Authorization in Arkansas
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Arkansas practices and billing companies at $1,900 per seat per month. Full time, worked during Arkansas business hours, inside your own system.
What is specific to Arkansas
Arkansas covers much of its expansion population through ARHOME, which buys qualified health plan coverage from commercial carriers, so those members carry a commercial plan card alongside their Medicaid eligibility.
Arkansas’s Medicaid program is Arkansas Medicaid. Practices with a meaningful Arkansas Medicaid mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
Medicare here is adjudicated by Novitas Solutions, jurisdiction JH — shared with Louisiana, Mississippi, Oklahoma and Texas, but not with Missouri (WPS) or Tennessee (Palmetto GBA). CMS publishes the jurisdictions; checked September 2026.
What a prior authorization seat does in Arkansas
Submitted before the date of service and chased through the payer's decision window.
An authorisation found after the visit is a write-off, not a denial to appeal. In Arkansas the work is submitting ahead of scheduling and chasing the decision, against a payment clock that starts only once a clean claim lands.
- Authorizations submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when required
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Worked during Arkansas business hours, not queued overnight
For the statute behind all of this — Arkansas’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Arkansas billing page.
Arkansas Medicaid, in practice
Mostly fee-for-service, with two carve-outs rather than general MCOs: the PASSE program (provider-led risk-bearing entities; the DHS fact sheet states 'There are four organizations in Arkansas that follow the PASSE model') covers only high-need behavioral-health and IDD beneficiaries, while Medicaid expansion adults are covered through ARHOME premium assistance into commercial Marketplace plans. Source: humanservices.arkansas.gov
Arkansas buys private commercial coverage for its Medicaid expansion population instead of enrolling them in Medicaid managed care: 'The State proposes to continue to provide premium assistance to purchase coverage offered by Qualified Health Plans (QHPs) that participate in the individual insurance Marketplace in Arkansas.' Practically, an ARHOME patient presents a commercial QHP card and the claim is billed to that carrier under commercial rules, not to Arkansas Medicaid — so eligibility checks that stop at the Medicaid portal will mis-route the claim. Source: humanservices.arkansas.gov
For authorisations it decides who you ask. A carve-out means the rules, the portal and the turnaround belong to a different administrator from the one handling the rest of the member’s care, and an authorisation obtained from the wrong one is not an authorisation.
Working Arkansas hours
Arkansas runs on Central time, 11 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 8pm to 4am, and 7pm to 3am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Arkansas hours and nobody else’s.
What it costs in Arkansas
$1,900
Per seat, per month, in US dollars — $22,800 a year for one full-time person, forty hours a week, on Arkansas hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Arkansas run $1,500 to $2,500; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Arkansas
About a week from a signed agreement to a person working your queue, and that week of training is not billed on top. The week, step by step, and what is signed before anyone has access.
If working with staff outside the United States is new to your practice, see how a medical billing company structures that seat and why offshore medical billing does not have to mean losing visibility into the work.
Questions
Do you work with Arkansas practices?
Yes. Arkansas accounts are worked during Arkansas office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Arkansas?
Arkansas covers much of its expansion population through ARHOME, which buys qualified health plan coverage from commercial carriers, so those members carry a commercial plan card alongside their Medicaid eligibility.
Which Medicare Administrative Contractor covers Arkansas?
Novitas Solutions, the A/B MAC for jurisdiction JH. Medicare Advantage and commercial plans run their own authorizations; for traditional Medicare, the hospital outpatient services on CMS’s prior authorization list are reviewed by this MAC.
When does a Arkansas payer have to pay a clean claim?
30 days for clean claims submitted electronically, 45 days for claims submitted by other means. The deadline is in the Arkansas Insurance Department rule (23 CAR § 15-110, Rule 43), not the statute — Ark. Code § 23-66-215 only sets the 12% per annum late-payment penalty and delegates the timeframe to the Commissioner. The authorization gets the service approved; this is the deadline for paying the claim that follows it, once that claim is clean.
How fast must Arkansas Medicaid decide a prior authorization?
Under the federal CMS-0057-F rule, from 1 January 2026: 72 hours for an expedited request and seven calendar days for a standard one, for Medicaid fee-for-service and Medicaid managed care plans alike, counted in calendar time whether the request went by portal, fax or phone. The calculator at softhomeglobal.com/prior-auth-deadline works out the date.
How much does prior authorization cost in Arkansas?
$1,900 per seat per month — $22,800 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Arkansas queue?
Arkansas is on Central time, 11 hours behind Rawalpindi. The shift here runs 8pm to 4am so your seat is at a desk for your full working day, shifting to 7pm to 3am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Arkansas Medicaid as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Arkansas Medicaid has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
More for Arkansas
Next step
One seat on your Arkansas work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com