20 CAR § 835-623 – Surgical and hospital insurance

(a) Insurance benefits must be used first in paying for surgical and medical services.
(b) Arkansas Rehabilitation Services will pay a portion of the billed amount after comparable services, similar benefits, and insurance are applied.
(c) The authorized payment will be based on the most current Medicare Fee Schedule.
(d)
1. (1) If the service is not covered by Medicare, payment will be based on the current Arkansas Workers’ Compensation Commission Fee Schedule (Medical or Laboratory).
2. (2) For services covered by neither Medicare nor the Arkansas Workers’ Compensation Commission, Arkansas Rehabilitation Services will pay up to fifty percent (50%) of the total charges billed for the surgical or medical services.
(e) For hospitals or clinics with which Arkansas Rehabilitation Services has a contract establishing an all-inclusive amount for services, Arkansas Rehabilitation Services will pay the contract amount without regard to Medicare or Workers’ Compensation-based fee schedules.