Agency Provider Certification
- ARChoices Provider Certification Application (download | save | complete | print)
- Targeted Case Management Provider Application (download | save | complete | print)
- ARChoices Provider Certification Requirements
New Applicant Instructions
For first-time providers or if applying for a new provider service, follow these steps:
- Contact the Division of Provider Certification and Quality Assurance (DPSQA) staff for your application. However, if you are applying for personal care services, skip step two and follow step three by contacting the Arkansas Health Department.
- You will then receive a provisional letter from DPSQA provider certification unit after receiving required documents.
- Contact the Arkansas Health Department (AHD) to complete their licensing process at 1-800-462-0599. You will provide AHD with a copy of the provisional letter from us to them.
- Verify you are licensed or received licensure by AHD before applying for your Medicaid provider identification number at https://portal.mmis.arkansas.gov/armedicaid/provider/Home/ProviderEnrollment/tabid/477/Default.aspx.
- Please carefully read the Medicaid regulations for this program prior to submitting your application to Medicaid. Sections I, III, and IV apply to Medicaid providers. Section II applies specifically to the ARChoices program. Providers are responsible for abiding by all sections.
- Once you read through the regulations, apply for your Medicaid provider identification number to complete the certification process. Please allow 30-60 days for processing.
- The DPSQA Certification Unit will mail you a certificate with your PIN and expiration date when all steps have been completed.