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Arkansas Billing Guide

Last update
December 23, 2022

This Billing Guide outlines the workers’ compensation billing requirements for Arkansas.

Billing Form Requirements

Forms

Services

daisyBill Resources

CMS-1500*

Physician Services

CMS-1500 Instructions

UB-04 (UB-92 replacement)

Facility

No Form Specified

Pharmacy

No Form Specified

Dental

State-Mandated Physician Reporting Requirements

Arkansas requires the physician to submit the following reports to document injured worker status.

Document

Due

 Form Link

Initial Report

When treatment commences

Form AR- 3 Physician's Report

Progress Report

Every 60 days

Form AR- 3 Physician's Report

Final Report

When the patient is released

Form AR- 3 Physician's Report

Electronic Billing Mandate

The Arkansas Workers’ Compensation Commission has not issued electronic billing regulations or rules for medical bills. Accordingly, contact the payer to determine if workers’ comp bills can be submitted electronically.

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