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Medicaid Utilization Management Program (MUMP) 

The Arkansas Department of Human Services instituted the Medicaid Utilization Management Program (MUMP) to determine reimbursement for lengths of stay for all inpatient acute care/general and rehabilitative hospital services. Services performed in lone standing psychiatric facilities are excluded.

AFMC performs the review under contract to Arkansas Medicaid.

Groups affected
Telephone procedure
Contact info

Groups affected

All age groups and Medicaid eligibility categories, except for recipients under age 1, are affected by this policy. The policy includes all acute care/general and rehabilitative hospitals, in or out-of-state. Please see item 5, Transmittal No. 52, for the procedure to follow when a child's first birthday occurs during an inpatient stay.

Instructions for applying the MUMP procedures are detailed in the Arkansas Medicaid Provider Manual. (Section 213.31, page II-25 through II-28)

Telephone procedure

The procedure for the MUMP telephone review with AFMC is as follows:

  1. Patient name and address (including zip code)
  2. Patient birth date
  3. Patient Medicaid number
  4. Admission date
  5. Hospital name
  6. Hospital Medicaid provider number
  7. Attending physician Medicaid provider number
  8. Principal diagnosis and other diagnoses influencing this stay
  9. Surgical procedures performed or planned
  10. The number of days being requested for continued inpatient care
  11. All available medical information justifying or supporting the necessity of continued stay in the hospital

Contact info

AFMC pre-certification: Call 800-426-2234

AFMC phone review hours: 8:30 a.m.-12 p.m. and 1 p.m.-5 p.m. Monday through Friday, with the exception of holidays. All calls are monitored for quality assurance purposes.

Questions?

E-mail: Internal review manager/AFMC
mump_contact@afmc.org

Authorization for procedures, assistant surgeons or length of stays indicates that AFMC has determined medical necessity. It does not indicate that the patient is eligible for Medicaid coverage. The provider is responsible for verifying patient eligibility for the dates of service.