Patient Centered Medical Home

PCMH Enrollment Eligibility

All four of these requirements must be met to be eligible for enrollment as a PCMH

The Provider entity must be one of the following:

An individual Primary Care Physician (PCP) (Medicaid Provider Types 01 or 03)
A physician group of Primary Care Providers who are affiliated with a common group Medicaid identification number (Provider Types 02 or 04)
A Rural Health Clinic (Medicaid Provider Type 29) as defined by the Rural Health Clinic Provider Manual, Section 201.000

The practice must include PCPs enrolled in the ConnectCare Primary Care Case Management program

The practice may not participate in the PCCM Shared Savings Program established under AR Act 1453 of 2013

The practice must have at least 125 attributed beneficiaries at the time of enrollment

PCMH Manual and Supplemental Materials

Forms

DMS-844, Practice Participation Agreement/Update Change Form

DMS 845, Pooling Request Form

DMS 846, Practice Withdrawal Form

Provider Inquiries and Assistance

Gainwell Technologies – PCMH Help Desk
Phone: 501.301.8311 or 866.322.4696
Fax: 501.374.0549
General Inquiries/Enrollment Applications: [email protected]

Arkansas Foundation for Medical Care
Phone: 501.212.8600
Fax: 501.375.1201
Email: [email protected]
Website: www.AFMC.org

Arkansas Foundation for Medical Care, Practice Transformation
Rhelinda McFadden, RN CPHIT, CPEHR
Manager, PCMHPT/Quality Consultant
1020 West 4th Street, Suite 200
Little Rock, Arkansas 72201
Phone: 501.212.8733
Fax: 501.375.0705
Email: [email protected]
Email: [email protected]
Website: www.afmc.org

Other Contacts

Arkansas Chapter
American Academy of Pediatrics
Anna Strong
P. O. Box 251182, Little Rock, Arkansas 72225
Phone: 415.902.3927
Email: [email protected]
Website: www.arkansasaap.org

Arkansas Chapter American Academy of Family Physicians
Carla Coleman
500 Pleasant Valley Dr. Suite #102
Little Rock, AR 72227
Phone: 501.223.2272
Email: [email protected]
Website: www.ArkansasAFP.org

Arkansas Office of Health Information Technology (OHIT) – AR SHARE
Anne Santifer
HIT Director
Phone: 501.410.1999
Email: [email protected]
Website: https://sharearkansas.com/