Provider Services
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Services Offered: |
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Eligibility Verification System (ELVS)
1-800-338-7752 (Toll Free)
Services Offered:Medicaid eligibility verification tool using automated voice response.Contact Information:
800-338-7752 (Toll Free)
515-323-9639 (locally in Des Moines)
ELVS Portal
Operating Hours:
24 hours per day 7 days a week
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Provider Audits and Rate Setting (Provider Cost Audit)
1-866-863-8610 (Toll Free)
Services Offered:For questions related to submitted Medicaid cost reports and cost settlement payments.Contact Information:
P.O. Box 36450
Des Moines, IA 50315
866-863-8610 (Toll Free)
515-256-4610 (Des Moines area)
515-725-1353 (Fax)
Operating Hours:
Monday - Friday
8:00 am - 5:00 pm
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Medical Support
1-800-383-1173 (Toll Free)
Services Offered:This unit consists of medical professionals and affiliated staff that provide medical review consideration on specific areas such as coverage and benefits as well as assisting with exceptions to policy, prior authorizations and appeals.Contact Information:
P.O. Box 36478
Des Moines, IA 50315
800-383-1173 (Toll Free)
515-256-4623 (Des Moines area)
515-725-1355 (General Fax)
515-725-1349 (Fax Long Term Care)
515-725-0931 (Fax Remedial Authorization)
515-725-0420 (Fax Remedial Progress Notes)
Operating Hours:
Monday - Friday
8:00 am - 4:30 pm
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Medical Prior Authorization
1-888-424-2070 (Toll Free) -
Services Offered:
For providers requesting medical prior authorization (PA), pre-procedure requests, and to provide supporting documentation for prior authorizations including medical reports, photos and x- rays.
Contact Information:
P.O. Box 36478
Des Moines, IA 50315
888-424-2070 (Toll Free)
515-256-4624 (Des Moines area)
515-725-1356 (Fax)
515-725-0938 (Dental PA Fax)
Operating Hours:
Monday - Friday
8:00 am - 4:30 pm -
Program Integrity
1-877-446-3787 (Toll Free)
Services Offered:For clinical records requests, payments related to findings and to report fraud referrals.
Contact Information:
P.O. Box 36390
Des Moines, IA 50315
877-446-3787 (Toll Free)
515-256-4615 (Des Moines area)
515-725-1354 (Fax)
Program Integrity Webpage
Operating Hours:
Monday - Friday
8:00 am - 4:30 pm
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Third Party Liability (TPL)
1-866-810-1206 (Toll Free)
Services Offered:Coverage updates from insurance carriers, insurance carrier payments, and claim adjustments due to third party liability.
Contact Information:
P. O. Box 36475
Des Moines, IA 50315
866-810-1206 (Toll Free)
515-256-4619 (Des Moines area)
515-725-1352 (Fax)Operating Hours:
Monday - Friday
8:00 AM - 4:30 PM
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Pharmacy Prior Authorization (PA) Hotline
1-877-776-1567 (Toll Free)
Services Offered:Prior authorization for prescriptions.
Contact Information:
877-776-1567 (Toll Free)
515-256-4607 (Des Moines area)
1-800-574-2515 (Fax Only)
Operating Hours:Monday - Friday8:00 AM - 5:00 PM
Fax number is operational 24/7
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Pharmacy Point-of-Sale (POS) Hotline
1-877-463-7671 (Toll Free)
Services Offered:Provider inquiries regarding claims, credit/adjustments, specific to pharmacy. Drug rebate including supplemental.
Contact Information:
P.O. Box 310195
Des Moines, IA 50331-0195877-463-7671 (Toll Free)515-256-4608 (Des Moines area)Operating Hours:
Monday - Friday
8:00 AM - 5:00 PM -
Electronic Data Interchange Support Services (EDISS)
1-800-967-7902 (Toll Free)
Services Offered:Enrollment for EDI transactions, PC-ACE Pro32 related questions, password resets (Total On-Boarding (TOB), Bulletin Board System (BBS) or the Iowa Medicaid Web Portal), and electronic claim submission ANSI formatting related questions. -
Medicaid Claims
1-800-338-7909 (Toll Free)
Services Offered:For submission of paper Medicaid claims. Includes all submissions within 1 year from date of service and retroactive eligibility claims between 12 to 23 months from the date of service.
Contact Information:P.O. Box 150001Des Moines, IA 50315800-338-7909 (Toll Free)515-256-4609 (Des Moines area)
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