Medicaid Provider Services

Medicaid Town Hall Meetings [1]: Iowa Medicaid is holding regular virtual town hall meetings with providers to gather feedback on the current state of the program and how to improve. Find more information on the Medicaid Town Halls page [1].

Iowa Medicaid is gathering feedback from providers on how to improve provider outcomes to better serve members. Take the survey [2]. Read Informational Letter 2279-MC-FFS-D [3] for more details.

Medicaid Provider COVID-19 Resources [4]

DHS has a new resource for stakeholders to understand how the Medicaid program operates in Iowa. The 2021 Iowa Medicaid Reference Guide [5] provides an overview of both the state's Medicaid program as well as the Children's Health Insurance Program (CHIP), including program eligibility, covered services, state oversight, budget development, and the governing framework of the programs. DHS plans to update the guide annually before each legislative session. The guide is available here [5].

The Iowa Medicaid Enterprise (IME) is privileged to work with talented and qualified professional health care providers in the State of Iowa. The IME works in collaboration with our partners in the health care industry in order to provide quality and cost-effective access to health care for Iowa Medicaid members. On April 1, 2016, the Iowa Department of Human Services transitioned most Iowa Medicaid members to a managed care program called IA Health Link. This program is administered by two contracted Managed Care Organizations (MCOs) that provide members with comprehensive health care services, including physical, behavioral and long term care services and support. We encourage all providers to contract with the MCOs and to continue working with them to complete contracts and credentialing requirements. Contracting with the MCOs is necessary to continue providing care to Medicaid members. For more information regarding the Iowa Medicaid transition to managed care, please read the IA Health Link Frequently Asked Questions [6]. You will also find more provider-specific information regarding the managed care transition on the Medicaid Modernization [7] web page.

Stay informed on the most up-to-date information, changes, and policies regarding Iowa Medicaid!

Provider Services Contact Information
800-338-7909 Toll Free 515-256-4609 (Des Moines area) (Monday to Friday from 8:00 a.m. to 5:00 p.m. Central Time) 515-725-1155 (Fax) Provider Services P.O. Box 36450 Des Moines, IA IA 50315 MCO Provider-Specific Contact Information [9]

News and Announcements
Video Tips on Filling Out Prior Authorization Form and Nursing Facility Level of Care (LOC) Certification Form: The IME has released two videos that provide tips on how to fill out a Prior Authorization form [10] and a Nursing Facility LOC certification form [11]. Home- and Community-Based Services (HCBS) Intellectual Disability (ID) Waiver Tiered Rate Fee Schedule: The following are the procedure codes and tiered rate fee schedule for the ID Waiver daily SCL, full day Day Habilitation and full Adult Day Care services. Access the HCBS ID Waiver Tiered Rate Fee Schedule [12]. Work Process Flow Charts for Various Medicaid Programs: Presented below are flow charts that outline different work flows that illustrate various policies and processes for various Medicaid programs. Flow Chart for Provider Enrollment Process [13] Flow Chart for Changing MCO [14] Flow Chart for Enrollment Process for New HCBS Waiver Members (FFS and MCO) [15] (Español [16]) Flow Chart for MCO Enrollment Process [17] Translation and Interpretation Services for Members: Iowa Medicaid can arrange for an interpreter to help members speak with us in almost any language. Members should call Iowa Medicaid Member Services for help at 1-800-338-8366 or locally in the Des Moines area at 515-256-4606.

News and Announcements

Video Tips on Filling Out Prior Authorization Form and Nursing Facility Level of Care (LOC) Certification Form: The IME has released two videos that provide tips on how to fill out a Prior Authorization form [10] and a Nursing Facility LOC certification form [11].

Home- and Community-Based Services (HCBS) Intellectual Disability (ID) Waiver Tiered Rate Fee Schedule: The following are the procedure codes and tiered rate fee schedule for the ID Waiver daily SCL, full day Day Habilitation and full Adult Day Care services. Access the HCBS ID Waiver Tiered Rate Fee Schedule [12].
Work Process Flow Charts for Various Medicaid Programs: Presented below are flow charts that outline different work flows that illustrate various policies and processes for various Medicaid programs.
- Flow Chart for Provider Enrollment Process [13]
- Flow Chart for Changing MCO [14]
- Flow Chart for Enrollment Process for New HCBS Waiver Members (FFS and MCO) [15] (Español [16])
- Flow Chart for MCO Enrollment Process [17]
Translation and Interpretation Services for Members: Iowa Medicaid can arrange for an interpreter to help members speak with us in almost any language. Members should call Iowa Medicaid Member Services for help at 1-800-338-8366 or locally in the Des Moines area at 515-256-4606.

IA Health Link Provider-Specific Information Materials [18]

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