September 9, 2016  |  Issue 25  |  Volume 1
Medicaid e-News
Public Notice:
Access Monitoring Review Plan
Pursuant to the provisions of title 42 Sections 447.203 through 447.205 of the Code of Federal Regulations, public notice and public comment are required for the access monitoring review plan. Public notice and request for comment has been published and can be viewed   here .

Performance and Reports:
IA Health Link Performance Reports--Now Available!
Performance monitoring and data analysis are critical components in assessing how well the managed care organizations (MCO) are maintaining and improving the quality of care delivered to members. The monthly and quarterly data reports are a snapshot in time with information on major contract compliance areas and member enrollment. The department examines the data from a compliance perspective and conducts further analysis if any issues are identified.

Monthly reports are now posted and can be found here.

Quarterly reports are now posted and can be found here.

Tools and Resources:
Prior Authorization Summary by Plan 
The Iowa Medicaid Enterprise (IME) has put together a prior authorization (PA) summary by plan. Providers can quickly view and compare PA requirements for each plan with this easy-to-use chart. This chart has been updated with the most current requirements for each Managed Care Organization (MCO). View the PA requirements by plan here.
 
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:


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.
 
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.

Provider Services

Informational Letters
Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website  here .  These letters communicate important policies and procedures for providers and their administrative staff. 


Non-Emergency Medical Transportation
Members may contact their assigned non-emergency medical transportation (NEMT) broker at the numbers below to schedule their  NEMT services:

Amerigroup Iowa Inc.
Logisiticare
1-844-544-1389

AmeriHealth Caritas, Iowa Inc.
Access2Care
1-855-346-9760

UnitedHealthcare Plan of the River Valley, Inc.
MTM
1-888-513-1613
_________________

Medicaid 
Fee-for-Service 
Access2Care/TMS
1-866-572-7662

Iowa Medicaid Enterprise | IMECommunications@dhs.state.ia.us | dhs.iowa.gov
100 Army Post Rd., Des Moines, IA 50315

Copyright © 2016. All Rights Reserved.