November 15, 2017 | Issue 18 | Volume 2
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AmeriHealth Caritas to Withdraw from the IA Health Link Program
AmeriHealth Caritas is withdrawing from the IA Health Link managed care program effective November 30, 2017. AmeriHealth Caritas members' coverage with their new MCO will begin on December 1, 2017.
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Provider Enrollment with Managed Care Organizations (MCOs)
During the transition from Amerihealth Caritas, providers currently enrolled with the Iowa Medicaid Enterprise (IME) will be considered to have "deemed enrollment" with both UnitedHealthcare and Amerigroup for the month of December 2017.
"Deemed enrollment" means that Medicaid enrolled providers are provisionally considered credentialed with each MCO to allow for continued access to
care.
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TODAY: UnitedHealthcare Job Fair
On December 1, UnitedHealthcare will begin serving 200,000 Iowa Medicaid members who previously were enrolled through AmeriHealth. After that transition is complete, the company will manage and coordinate the care of more than 400,000 Iowans through the IA Health Link program.
To continue providing high-quality care to this larger population of Iowans, UnitedHealthcare is expanding its team here in central Iowa by hiring 70 new case managers.
To fill these positions, the company will hold a job and informational fair on Wednesday, November 15, from 8 a.m. to 3:30 p.m. at the Tuscany Event Center, located at 3901 NW 121st Street in Urbandale, IA.
At the same event, consumer-directed attendant care (CDAC) providers will be able to register with UnitedHealthcare. Those unable to attend can start their registration process by sending an email to IowaCommunityNetwork@UHC.com.
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Tiered Rates
Per House File 653, the Department of Human Services (DHS) was directed to implement tiered rates for providers of daily supported community living (SCL), full day-habilitation and full day-adult day care for persons with an intellectual disability under the home- and community-based services (HCBS) waiver program.
Tiered rates aligns reimbursement based on the severity of the individuals' disabilities and will standardize reimbursement for all providers. Approximately 5,000 members will have their services reimbursed using tiered rates.
Tiered rate reimbursement for daily SCL will be phased in over 19 months beginning December 1, 2017. This phased in approach allows providers time to adjust their business practices. For more information view the
Tiered Rates FAQ and
Informational Letter 1846-MC-FFS.
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Member Choice Guidelines for Providers
All health care providers delivering services to Iowa's Medicaid population in the IA Health Link managed care program are welcome to inform their patients of the health plans in which they have chosen to participate. However, there are strict prohibitions against patient steering, which all providers must observe.
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Non Emergency Medical Transportation (NEMT)
AmeriHealth Caritas members should continue scheduling rides with their AmeriHealth Caritas' NEMT broker until December 1, 2017, regardless of the appointment date. AmeriHealth Caritas will transition member information, including NEMT appointment information, to the member's new Managed Care Organization (MCO).
Beginning December 1, 2017, members should contact their new MCOs' NEMT broker to schedule rides.
NEMT contact information to schedule a ride:
Amerigroup Iowa
Logisticare: 1-844-544-1389
AmeriHealth Caritas
Access2Care: 1-855-346-9760
UnitedHealthcare
MTM: 1-888-513-1613
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Provider Tools and Resources:
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Provider Resource Pages
Comprehensive provider resource pages are available for each Managed Care Organization (MCO), featuring provider training manuals, webinars and important updates. View them below:
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Verify Eligibility
The Eligibility and Verification Information System (ELVS) line is very busy during the first of the month. The
ELVS web portal is another option for providers in lieu of calling the ELVS line but each provider must enroll through the Electronic Data Interchange Support Services (EDISS). The ELVS web portal allows for multiple eligibility checks and batch submission, where as the ELVS phone system only allows for one at a time.
Login ID and password may be obtained through EDISS by submitting the following
Access Request Form to EDISS or calling EDISS at 1-800-967-7902.
For more information, please see Informational Letter 1650-MC available here.
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Looking for an Old Issue of the Medicaid e-News?
Each edition features useful tools and important updates. Now you can quickly access old issues to find what your looking for. Visit the
Iowa Medicaid newsletter page
where you'll find links to each issue.
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IA Health Link Member Services
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1-800-600-4441
1-855-332-2440
1-800-464-9484
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IA Health Link Provider Services
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1-800-454-3730
1-844-411-0579
1-888-650-3462
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Dental Wellness Plan Member Services
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Dental Wellness Plan Provider Services
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Informational Letters
Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website
here
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These letters communicate important policies and procedures for providers and their administrative staff.
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100 Army Post Rd., Des Moines, IA 50315
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Copyright © 2017. All Rights Reserved.
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The Iowa Medicaid Enterprise (IME), has been named a 2016 All Star Award winner by
Constant Contact
, part of the
Endurance International Group, Inc.'s
(Nasdaq: EIGI) family of brands and the trusted marketing advisor to hundreds of thousands of small organizations worldwide. The annual award recognizes the most successful 10 percent of Constant Contact's customer base, based on their significant achievements using email marketing to engage their customer base and drive results for their organization during the prior year.
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