CurrentCareSourcePolicy Interest Payments-AR PASSE-PY-1314

Interest Payments — Arkansas PASSE reimbursement

Defines CareSource's reimbursement policy for payment of interest on late claim payments under Arkansas prompt payment regulations for PASSE providers; affects CareSource providers submitting claims in Arkansas.

Policy Summary

PayerCareSource

PolicyInterest Payments — Arkansas PASSE reimbursement

Policy CodePolicy Interest Payments-AR PASSE-PY-1314

Change TypeNon-material reference updates

Effective Date04/01/2025

Next Review Date

Key ActionSubmit accurate and appropriate CPT/HCPCS/ICD-10 codes and claim data; interest applies only to clean claims adjudicated after applicable prompt pay timeframes.

SourceLink

POLICY UPDATE CHANGES

Updated references (01/31/2024) and committee approval/updated references (01/15/2025).

ARJurisdiction

04/01/2025Effective

03/31/2022→01/31/2024→01/15/2025Revisions

AR § 23-66-215Reg reference

Interest Payment Eligibility

Interest payment criteria

Conditions under which interest is paid or excluded:

Pay interest on original clean claims when CareSource fails to adjudicate within applicable state and federal prompt pay timeframes.

Interest on adjusted claims begins on the date the provider disputes the original payment with CareSource.

If CareSource had the information to pay the claim correctly on a prior processing attempt but failed to do so, interest will accrue and be paid in accordance with the Prompt and Interest Regulations (interest begins accruing when payment is not made within the Prompt Pay timeframe).

Contractual adjustments to a claim are not subject to state or federal regulations for interest payment and therefore are excluded from interest payments.

Policy Summary

PayerCareSource

PolicyInterest Payments — Arkansas PASSE reimbursement

Policy CodePolicy Interest Payments-AR PASSE-PY-1314

Change TypeNon-material reference updates

Effective Date04/01/2025

Next Review Date

Key ActionSubmit accurate and appropriate CPT/HCPCS/ICD-10 codes and claim data; interest applies only to clean claims adjudicated after applicable prompt pay timeframes.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Claim Coding and Timeliness

Required coding on claimsmixed

CPT/HCPCS/ICD-10

Claims must include appropriate CPT, HCPCS and ICD-10 codes and applicable modifiers

Clean claim timeliness

Clean claim timelinessInterest is paid when CareSource fails to adjudicate clean original claims within applicable state and federal prompt pay timeframes (per AR Code § 23-66-215 (2024)).

ScopeApplies to original, clean claims submitted under Arkansas prompt pay regulations for PASSE providers.

ExclusionsContractual adjustments are not subject to state or federal interest-payment regulations.

Accrual timingInterest begins accruing when payment is not made within the Prompt Pay timeframe; if CareSource had information to pay correctly previously but failed, interest accrues per Prompt and Interest Regulations.

Provider Submission Requirements & Interest Eligibility

Billing Rule

Claims submission and interest eligibility

Providers must submit the most accurate and appropriate CPT, HCPCS and ICD-10 code(s) (including applicable modifiers) for the product or service being provided. Interest is payable only on clean original claims that CareSource fails to adjudicate within the applicable state and federal prompt pay timeframes; interest does not apply to claims corrected proactively by CareSource or to contractual adjustments.

Submit accurate CPT/HCPCS/ICD-10 codes and applicable modifiers on all claims.
Interest applies only to clean original claims adjudicated after applicable prompt pay timeframes (AR Code § 23-66-215 (2024)).
Adjusted claims interest accrues from the date the provider disputes the original payment.
Claims corrected proactively by CareSource (e.g., retroactive eligibility, authorizations, COB, fee schedule updates) or contractual adjustments are not eligible for interest.

Key Definitions

Adjusted Claim

DefinitionAdjusted Claim: result of a request by the provider or CareSource to change historical data or reimbursement of an original claim.

Interest start dateInterest on adjusted claims starts on the date the provider disputes the original payment with CareSource.

Relation to original claimAn adjusted claim modifies the historical reimbursement or data of an original claim; it is distinct from a contractual adjustment for which interest is not payable.

Original Claim

DefinitionOriginal Claim: the initial complete claim for one or more benefits on an application form.

Role in interest paymentsInterest payments on original claims are owed when CareSource fails to adjudicate clean original claims within prompt pay timeframes.

DocumentationOriginal claims must include required data elements on standard claim forms and any necessary attachments to be considered clean.

Clean Claim

DefinitionClean Claim: a claim with no defect, impropriety, special circumstance, or incomplete documentation that would delay timely payment; provider must submit required data elements and attachments accurate at time of payment.

Eligibility for interestOnly clean claims are eligible for interest payments when not adjudicated within prompt pay timeframes.

Provider responsibilityProviders must provide required data elements, attachments, and revisions of which they have knowledge to submit a claim as clean.

Prompt Payment

DefinitionPrompt Payment: defined by state and/or federal regulation specifying timeliness and interest requirements (referenced: AR Code § 23-66-215 (2024)).

Trigger for interestInterest begins accruing when payment is not made within the Prompt Pay timeframe established by applicable regulations.

Regulatory adherenceCareSource strictly adheres to prompt payment regulations and follows their guidelines for interest payments.

OpenPayer

Interest Payments — Arkansas PASSE reimbursement

Interest Payment Eligibility

Claim Coding and Timeliness

Provider Submission Requirements & Interest Eligibility

Key Definitions

Policy Revision History