Provider-Specific Resources



IMPORTANT UPDATE--TEMPORARY SUSPENSION OF MCO CHOICE

AmeriHealth Caritas Iowa, Inc. withdrew from the IA Health Link managed care program effective November 30, 2017. AmeriHealth Caritas members have been assigned to UnitedHealthcare. The department has put in place a temporary suspension of Managed Care Organization (MCO) choice.
 
Previously the Department notified members they would be able to choose Amerigroup Iowa. Due to concerns with capacity, Amerigroup Iowa is not accepting any additional members at this time. This also includes all new IA Health Link members. In the future members will be able to choose from multiple MCOs. Members will be notified when that choice is available. 
 
AmeriHealth Caritas’ members transitioned to UnitedHealthcare effective December 1, 2017. Learn more by reading the sample member letter, the Press Release and the FAQs below.   
 

FAQ for Members

FAQ for Providers

Updated information will be posted as it is available. Please check back regularly.

Provider Applications
 
Managed Care Covered Benefits
The Iowa Medicaid Enterprise (IME) has developed a comparison document which provides information on basic required benefits for Medicaid, Iowa Health and Wellness Plan, hawk-i and the Iowa Family Planning Network. View the Comparison Grid here.
 
Prior Authorization (PA) Summary by Plan
The Iowa Medicaid Enterprise (IME) has put together a prior authorization (PA) summary by plan. Quickly view and compare PA requirements for each plan with this easy-to-use chart. Download and print the PA requirements by plan.
 
Vision Benefit Guide
The Iowa Medicaid Enterprise (IME) has put together a vision benefit summary by plan for the IA Health Link managed care program. Providers can quickly view key contact information and requirements for each plan and each coverage group with this easy-to-use chart. View the vision benefit guide here.
 
Managed Care Quick Reference Guide
The Iowa Medicaid Enterprise (IME) has put together a useful resource guide for the front desk or administrative staff of providers which includes important phone numbers, claims submission information and more. Download and print the Managed Care Quick Reference Guide.
 
Work Process Flow Charts for Various Medicaid Programs
Iowa Medicaid provides health coverage to more than 640,000 Iowans through a variety of different programs. These programs have processes in place to make sure members get the care they need. Some processes are complex, but important to understand. The Iowa Medicaid Enterprise (IME) has developed visual aids to help members, providers and stakeholders better understand the various processes in place at the IME. 
 
Translation and Interpretation Services
Medicaid is federally obligated to provide translation services. Translation services are available to IA Health Link members—through their Managed Care Organization (MCO)—and are also available for Iowa Medicaid Fee-for-Service (FFS) membersRead More.
 
Member Choice
 
 

MCO Provider Resources:
Managed Care Organization (MCO) Contact Information 
 
Managed Care Organization (MCO) Provider Training Presentation Slides 
Amerigroup 
Amerihealth Caritas
UnitedHealthcare
 
Managed Care Organization (MCO) Provider Resource Pages 
Amerigroup.com/IAProvider
 

Managed Care Organization (MCO) Provider Manuals 
Amerigroup Iowa, Inc. (December 3, 2015)
AmeriHealth Caritas Iowa, Inc. (December 3, 2015)
UnitedHealthcare Plan of the River Valley, Inc. (December 3, 2015)


Additional Resources:
Informational Documents