CareSource PASSE™ may update this page with information about how to work with our plan.
What is CareSource PASSE?
PASSE stands for Provider-led Arkansas Shared Savings Entity. CareSource PASSE is the newest PASSE that was approved for Arkansas Medicaid. The PASSE system went live in Arkansas in March of 2019. CareSource PASSE will be the 4th option for Arkansans on Medicaid with complex behavioral health diagnosis and/or Intellectual/Developmental Disabilities.
Who are the CareSource PASSE Provider Equity Partners?
- Acadia Healthcare (Residential Behavioral Health, Acute Behavioral Health Facilities and an ICF)
- Ashley County Medical Center (Critical Access Hospital and Pharmacy)
- CareSource (Health Insurance Company)
- Chenal Family Therapy (Behavioral Health Agency)
- RehabNet (OT/PT/SPL Therapy Association)
- Zini Medical Clinic ( Dr. James Zini, DO) (Physician)
What Arkansas Medicaid Populations are enrolled in PASSE?
Only the following Medicaid populations are enrolled in PASSE:
- Individuals who have received a Tier 2 or Tier 3 determination from their Optum (ARIA) assessment
- Individuals receiving services through Developmental Disabilities Waiver
- Individuals who are on the Developmental Disabilities Waiver Waitlist
- Individuals who are in private Developmental Disabilities facilities (ICFs)
- Individuals who have a Behavioral Health Diagnosis and have received an Independent Assessment that determines they need services in Tiers 2 or 3
How can I find out more information about CareSource PASSE?
To learn more about CareSource PASSE go to www.CareSourcePASSE.com.
How do members enroll in CareSource PASSE?
Members are auto-assigned to a PASSE, after their Optum/ARIA assessment and scored a Tier 2 or Tier 3, and then have 90 days to change if they chose. Members can also change PASSEs one time a year during Open Enrollment.
Does a provider have to participate with CareSource PASSE to see CareSource PASSE members?
Being a participating provider is always best. Being a non-participating provider may require services to be prior- authorized and may require negotiation of a single case agreement. If there is an appropriate in-network provider to render such care, that member may be redirected to a participating provider.
In addition, non-participating providers do not have the support of having an assigned Provider Engagement Specialist and will have limited access to the CareSource PASSE provider portal.
How does a provider become participating with CareSource PASSE?
Providers can visit www.CareSourcePASSE.com to apply online for a Provider Contract. If you do not have consistent internet capability, send an email to Arkansas_Network@caresource.com to have a Network Consultant reach out to you. Please include the provider name, practice name, contact name, contact phone number, and, if applicable, a preferred contact date and time to make outreach.
*Lab and Vision providers:
- If you provide independent laboratory services and want to be part of the CareSource PASSE network, please email (Networkteam@avalonhcs.com) Avalon Healthcare Solutions or call them at 1-813-751-3940.
- If you provide routine vision services and want to be a part of the CareSource PASSE Network please contact Superior Vision (https://superiorvision.com/eye-care-professionals/join/).
Does the provider need to be an Arkansas Medicaid Provider?
Yes, in order to participate with CareSource PASSE, a provider must be registered with Arkansas Medicaid. Providers can apply at https://humanservices.arkansas.gov/divisions-shared-services/medical-services/provider-enrollment/ for Arkansas Medicaid Provider Enrollment Information. If you are not sure your provider is enrolled with Medicaid please check on https://portal.mmis.arkansas.gov/armedicaid/member/Resources/SearchProviders/tabid/97/Default.aspx, contact your Care Coordinator
How will a provider be reimbursed for CareSource PASSE?
Reimbursement will be 100% of current Arkansas Medicaid rates and methodology for services in which there is a published Arkansas Medicaid fee schedule and/or rate.
For Home & Community Based Services that do not have published fee schedules, CareSource has developed the market fee schedules posted here https://www.caresource.com/documents/ar-pas-p-701150-hcbs-1915-custom-fee-schedule/
Will CareSource PASSE require a provider to be credentialed?
Yes, CareSource PASSE will begin the credentialing process, upon receipt of the provider’s completed credentialing application.
CareSource PASSE will pull down the MD’s/DO’s provider information from the CCVS. CareSource PASSE will need the CCVS attestation signed by each MD/DO. If you are an MD or DO and need more information about CCVS, please click here https://arccvs.org.
What is the process if a provider wants delegated credentialing?
CareSource will allow providers to have a delegated credentialing agreement. Providers will need to go through a pre-delegation audit and review for this to be approved. Please let your Health Partner know that you want to persue delegated credentialing or send an email to Arkansas_Network@caresource.com.
Please include the provider name, practice name, contact name, contact phone number, and, if applicable a preferred contact time to make outreach.
Will CareSource PASSE use a separate company/vendor to manage their behavioral health & substance abuse network and/or benefits?
No, CareSource PASSE directly contracts with all behavioral health and substance abuse providers, along with managing those benefits directly. It is important for CareSource PASSE to have these direct relationships to support their member-centric model of care and to address all the members’ health and social needs.
Who is the CareSource PASSE pharmacy manager and how do I contract to be a retail pharmacy?
CareSource PASSE provides pharmacy management through CareSource RxInnovations™ and accesses the Express Scripts pharmacy network. To contract with Express Scripts, please click here https://www.express-scripts.com/pharmacist/helpnet/net_enroll_form.htm
A pharmacy wanting to provide DME will need a separate agreement from their retail pharmacy agreement with Express Scripts. To join the CareSource PASSE network as a DME provider please go to the Become A Provider page.
What if a provider wants to know the status of their agreement/credentialing with CareSource PASSE?
Providers should know that it may take up to 60 days to complete the credentialing process. Providers can call Provider Services at 833-230-2100 to check their credentialing status. To be credentialed, the provider must have signed a participating provider agreement.
A reminder, Welcome Letters will not go out until closer to the “Go Live” date.
Does CareSource PASSE have a Provider Portal?
Yes. Once the provider is participating, directions on how to sign-up and access the provider portal will be included in their Welcome Packet and in Provider Orientation. The Provider Portal is secure and will allow them to:
- Submit CMS and UB claims
- Track benefit limits
- Submit Prior Authorization requests
- Search claim status
- See payment history
- See care treatment plans
- File a grievance
- Submit dispute and/or appeal
- See member profiles
Providers will not be able to login to the portal until closer to Go-Live and they will receive a “Welcome Letter” with all of the applicable information to register and have access to the portal.
Non-participating providers will have limited access to functions of the provider portal.
What company does CareSource PASSE use for claims clearinghouse purposes?
CareSource PASSE partners with Availity as the claims clearinghouse. All claims will need to be submitted to CareSource through Availity. The provider can use a different clearinghouse, however it will need the capability to submit to CareSource through Availity.
Please provide the clearinghouse with the CareSource PASSE payer ID number: ARCS1
Availity www.availity.com | 1-800-282-4548
What company does CareSource PASSE use for electronic funding purposes?
CareSource PASSE partners with ECHO Health for electronic fund transfers. Enrollment instructions can be found here: https://enrollments.echohealthinc.com/EFTERAInvitation.aspx
Who does CareSource PASSE use for Electronic Visit Verifications (EVV)?
CareSource PASSE is utilizing CareBridge to verify qualifying Personal Care (T1019) visits at Go Live. Additional HCBS services will be covered in the future. To contact or enroll with CareBridge please see below:
|AR Support Phone number||(844) 922-2584|
|AR Support Emailemail@example.com|
|Data Integration Support (for providers using a third party EVV)||firstname.lastname@example.org|
Where can a provider find a copy of the CareSource PASSE Provider Manual?
CareSource is in the process finishing up the CareSource PASSE provider manual. If the provider needs to see this in DRAFT version before signing the agreement send an email to Arkansas_Network@caresource.com to have a Network Consultant reach out to the provider. Please include the provider name, practice name, contact name, contact phone number, and, if applicable, a preferred time to make outreach.
Once finalized the Provider Manual will be accessible on the Provider Manual page.
What are the timely filing requirements?
CareSource PASSE will follow the PASSE timely filing requirements of 365 days from the date of service.