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
- An Area Health Education Center (AHEC) (Medicaid Provider Type 69)
- 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 150 attributed beneficiaries at the time of enrollment
PCMH Manual and Supplemental Materials
Additional Resources
| DMS-844 Practice Participation Agreement/Update Change Form | DMS 845 Pooling Request Form | DMS 846 Practice Withdrawal Form |
Provider Inquiries and Assistance
DXC Technology – APII Help Desk
Phone: APII help desk: 501.301.8311 or 866.322.4696
Fax: 501.374.0549
General Inquiries: ARKPII@dxc.com
Enrollment applications only: ARKPCMH@dxc.com
Arkansas Foundation for Medical Care
Phone: 501.212.8600
Fax: 501.375.1201
Email: PCMH@afmc.org
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: rmcfadden@afmc.org
Email: pcmhpt@afmc.org
Website: www.afmc.org
Other Contacts
Advanced Health Information Network (AHIN)
Telephone: 501-378-2336 or 855-822-2446
Email: customersupport@ahin.net
Website: https://secure.ahin-net.com/ahin/Session/logon
Arkansas Chapter
American Academy of Pediatrics
Kristen Pfeifer
Quality Improvement Manager
#1 Children’s Way, Slot 900
Little Rock, Arkansas 72202
Phone: 415.902.3927
Email: kristen_pfeifer@yahoo.com
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: ARAFP@sbcglobal.net
Website: www.ArkansasAFP.org
Arkansas Office of Health Information Technology (OHIT)
Jan Bartlett, JD
HIT Policy Director
Phone: 501.410.1990
Email: Janis.barlett@hit.arkansas.gov
Website: www.ohit.arkansas.gov
