Arkansas Data
Billing by Revenue Code
Bill Type / Revenue Code & Description / CoveredUnits
2014H2 / Covered
Units
2014H1 / Covered
Units
2013H2 / Prov.
Count
2014H2 / Cov. Units per Prov.
2014H2 / Bene
Count
2014H2 / Cov. Units per Bene
2014H2 / Cov. Units per Bene
2014H1 / Cov. Units per Bene
2013H2
32x / PT / 145,096 / 130,873 / 68,033 / 79 / 1,837 / 12,932 / 11 / 11 / 11
32x Total / PT / 9,544,326 / 8,964,276 / 6,231,145 / 6,719 / 1,420 / 765,894 / 12 / 12 / 13
33x / PT / 1,856 / 14,593 / 61,350 / 46 / 40 / 148 / 13 / 10 / 10
33x TOTAL / PT / 65,524 / 553,627 / 3,052,810 / 1,945 / 34 / 5,577 / 12 / 10 / 10
32x / OT / 27,765 / 22,472 / 11,471 / 61 / 455 / 4,425 / 6 / 6 / 7
32x TOTAL / OT / 2,262,850 / 2,112,980 / 1,354,482 / 5,482 / 413 / 321,029 / 7 / 7 / 8
33x / OT / 310 / 3,083 / 10,725 / 24 / 13 / 52 / 6 / 6 / 6
33x TOTAL / OT / 21,995 / 171,698 / 838,584 / 1,309 / 17 / 3,080 / 7 / 6 / 6
32x / SLP / 10,132 / 7,827 / 4,674 / 65 / 156 / 1,266 / 8 / 7 / 7
32x TOTAL / SLP / 514,549 / 461,168 / 303,757 / 3,865 / 133 / 67,850 / 8 / 7 / 8
33x / SLP / 47 / 1,134 / 3,584 / 8 / 6 / 12 / 4 / 8 / 6
33x TOTAL / SLP / 4,219 / 36,373 / 182,312 / 418 / 10 / 560 / 8 / 7 / 7
Bill Type / Revenue Code & Description / Covered
Units
2014H2 / Covered
Units
2014H1 / Covered
Units
2013H2 / Prov.
Count
2014H2 / Cov. Units per Prov.
2014H2 / Bene
Count
2014H2 / Cov. Units per Bene
2014H2 / Cov. Units per Bene
2014H1 / Cov. Units per Bene
2013H2
32x / SN / 270,530 / 244,003 / 151,436 / 83 / 3,259 / 18,004 / 15 / 15 / 15
32x Total / SN / 18,756,684 / 18,017,154 / 14,916,306 / 7,029 / 2,668 / 1,057,741 / 18 / 18 / 21
33x / SN / 2,380 / 20,357 / 97,815 / 48 / 50 / 201 / 12 / 11 / 12
33x TOTAL / SN / 79,747 / 749,948 / 4,690,087 / 2,286 / 35 / 6,893 / 12 / 11 / 12
32x / MSW / 2,106 / 1,734 / 1,190 / 42 / 50 / 1,280 / 2 / 2 / 2
32x TOTAL / MSW / 189,842 / 173,221 / 123,828 / 3,887 / 49 / 110,762 / 2 / 2 / 2
33x / MSW / 9 / 182 / 938 / 7 / 1 / 10 / 1 / 2 / 2
33x TOTAL / MSW / 1,189 / 11,338 / 66,105 / 480 / 2 / 771 / 2 / 2 / 2
32x / Aide / 79,925 / 75,162 / 63,813 / 81 / 987 / 4,765 / 17 / 17 / 22
32x TOTAL / Aide / 4,083,485 / 4,051,088 / 3,922,425 / 5,974 / 684 / 194,131 / 21 / 21 / 26
33x / Aide / 578 / 5,044 / 23,517 / 26 / 22 / 65 / 9 / 10 / 11
33x TOTAL / Aide / 19,877 / 148,528 / 786,631 / 986 / 20 / 1,671 / 12 / 10 / 11
State Billing
Bill Type / State / ProviderDisbursement
2014H2 / Provider
Disbursement
2014H1 / Provider
Disbursement
2013H2 / Prov.
Count
2014H2 / Prov. Dis.
per Provider
2014H2 / Bene
Count
2014H2 / Prov. Dis.
per Bene
2014H2 / Prov. Dis.
per Bene
2014H1 / Prov. Dis.
per Bene
2013H2 / Claim
Count
2014H2
32x Home Health / AR / 68,533,637 / 62,791,024 / 37,930,683 / 83 / 825,706 / 19,096 / 3,589 / 3,535 / 3,638 / 89,335,005
32x
Home
Health / TOTAL / $5,059,977,551 / $4,841,899,135 / $3,763,963,099 / 7,054 / $717,320 / 1,151,240 / $4,395 / $4,374 / $4,786 / 1,978,425
33x Home Health / AR / 660,490 / 5,947,884 / 27,243,928 / 50 / 13,210 / 208 / 3,175 / 3,056 / 3,238 / 875,585
33x
Home
Health / TOTAL / $28,577,805 / $245,998,844 / $1,482,608,228 / 2,344 / $12,192 / 7,422 / $3,850 / $3,361 / $3,695 / 8,214
Aggregate Length of Stay (LOS)
Median LOS / Mean LOS / Numberof
Benes / Number
of
Claims / % SSI / % Diabetes / % Vague
Therapy
AR / 60.0 / 161.5 / 19,651 / 30,248 / 3.0 / 6.1 / 7.9
J11 / 60.0 / 222.9 / 1,223,805 / 1,986,639 / 3.4 / 7.9 / 7.1
% Wound
Care / % Alzheimers / % Hypertension / % Benes with
Multiple
Providers / % Bene
with
Discharge / Disbursement per
Bene / Length of
Stay
AR / 3.4 / 0.5 / 4.5 / 27.7 / 15.4 / 3,521 / 3,099,261
J11 / 3.2 / 0.7 / 4.8 / 49.6 / 20.6 / 4,158 / 257,495,130
Top MR Denials All States
1 / 5FF2F / Face to Face Encounter Requirements Not Met / 3,813 / 72.1
2 / 56900 / Auto Deny - Requested Records not Submitted / 496 / 9.4
3 / 5CHG3 / MR HIPPS Code Change Due to Partial Denial of Therapy / 256 / 4.8
4 / 5F041 / Info Provided Does Not Support the medical necessity for This Service / 154 / 2.9
5 / 5FNOA / Unable to Determine medical necessity of HIPPS Code Billed as Appropriate Oasis Not Submitted / 133 / 2.5
6 / 5A041 / Info Provided Does Not Support the medical necessity for This Service / 127 / 2.4
7 / 5F012 / Physician's Plan of Care and/or Certification Present - Signed but Not Dated / 99 / 1.9
8 / 5TF2F / Face to Face Encounter Requirements Not Met / 90 / 1.7
9 / 5F023 / No Plan of Care or Certification / 59 / 1.1
10 / 5F011 / Physician's Plan of Care and/or Certification Present - No Signature / 58 / 1.1
Arkansas Medical Review Denials 2014
Denial Code / Denial Description / Claims / SubmittedCharges / Denied
Charges
NONE / NONE / 63 / $161,808 / $0
56900 / Auto Deny - Requested Records not Submitted / 4 / $10,359 / $10,359
5A301 / Info Provided Does Not Support the medical necessity for Therapy Services / 21 / $60,704 / $23,983
5CHG1 / MR HIPPS Code Change/Doc Contradicts MO Item(s) / 3 / $9,800 / $1,020
5CHG3 / MR HIPPS Code Change Due to Partial Denial of Therapy / 16 / $45,949 / $15,611
5DOW4 / Partial Denial Resulting in a LUPA / 1 / $2,434 / $2,077
5F012 / Physician's Plan of Care and/or Certification Present - Signed but Not Dated / 1 / $2,521 / $2,521
5F023 / No Plan of Care or Certification / 1 / $487 / $487
5F041 / Info Provided Does Not Support the medical necessity for This Service / 1 / $1,790 / $1,790
5F301 / Info Provided Does Not Support the medical necessity for Therapy Services / 2 / $7,258 / $7,258
5FF2F / Face to Face Encounter Requirements Not Met / 28 / $76,232 / $76,232
5FNOA / Unable to Determine medical necessity of HIPPS Code Billed as Appropriate Oasis Not Submitted / 2 / $4,036 / $4,036
5T071 / Services Billed Were More Than Ordered / 3 / $13,746 / $4,767
5T073 / Orders Not Signed &/or Dated Timely (VOs) / 2 / $6,537 / $2,270
5TF2F / Face to Face Encounter Requirements Not Met / 3 / $6,711 / $6,711
MRDWN / Medical Review Downcode / 1 / $3,291 / $1,295
152 / $413,663 / $160,417
Diagnosed Diabetes Incidence
County / Number of New CasesArkansas County / 182
Ashley County / 187
Baxter County / 346
Benton County / 985
Boone County / 285
Bradley County / 96
Calhoun County / 46
Carroll County / 179
Chicot County / 130
Clark County / 170
Clay County / 129
Cleburne County / 187
Cleveland County / 65
Columbia County / 195
Conway County / 167
Craighead County / 565
Crawford County / 379
Crittenden County / 396
Cross County / 142
Dallas County / 81
Desha County / 123
Drew County / 143
Faulkner County / 542
Franklin County / 129
Fulton County / 101
Garland County / 714
Grant County / 113
Greene County / 267
Hempstead County / 186
Hot Spring County / 242
Howard County / 119
Independence County / 264
Izard County / 107
Jackson County / 147
Jefferson County / 732
Johnson County / 170
Lafayette County / 76
Lawrence County / 142
Lee County / 97
Lincoln County / 106
Little River County / 111
Logan County / 170
Lonoke County / 331
Madison County / 100
Marion County / 131
Miller County / 316
Mississippi County / 353
Monroe County / 77
Montgomery County / 75
Nevada County / 72
Newton County / 67
Ouachita County / 229
Perry County / 81
Phillips County / 178
Pike County / 78
Poinsett County / 193
Polk County / 159
Pope County / 373
Prairie County / 72
Pulaski County / 2471
Randolph County / 151
St. Francis County / 230
Saline County / 664
Scott County / 81
Searcy County / 69
Sebastian County / 910
Sevier County / 102
Sharp County / 141
Stone County / 98
Union County / 337
Van Buren County / 131
Washington County / 947
White County / 518
Woodruff County / 74
Yell County / 145
State Diabetes Billing
Bill Type / Diagnosis Category / State / Provider Disbursement2014H2 / Provider
Disbursement
2014H1 / Provider
Disbursement
2013H2 / Prov.
Count
2014H2 / Prov. Dis.
per Provider
2014H2 / Bene
Count
2014H2 / Prov. Dis.
per Bene
2014H2 / Prov. Dis.
per Bene
2014H1 / Prov. Dis.
per Bene
2013H2 / Claim
Count
2014H2
32x Home Health / 250 Diabetes Mellitus / AR / 4,592,613 / 3,938,653 / 3,039,922 / 79 / 58,134 / 1,453 / 3,161 / 3,023 / 3,187 / 5,888,107
32x Home Health / 250 Diabetes Mellitus / TOTAL / $523,046,464 / $515,467,953 / $543,045,711 / 6,334 / $82,578 / 122,192 / $4,281 / $4,285 / 45,013 / 195,626
33x Home Health / 250 Diabetes Mellitus / AR / 22,904 / 235,286 / 1,217,641 / 10 / 2,290 / 10 / 2,290 / 2,614 / 2,872 / 33,015
33x Home Health / 250 Diabetes Mellitus / TOTAL / $1,623,308 / $13,811,969 / $82,403,594 / 375 / $4,329 / 449 / $3,615 / $3,262 / $3,299 / 494