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hawk-i
News and Announcements:
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Authorized Representative for Managed Care Appeals
Managed care appeals are mandated by Federal law. Federal regulations allow providers and authorized representatives to file an appeal on behalf of a
hawk-i member for managed care appeals when the member has given their express written consent.
While the Department has been complying with federal regulations, there was not a consistent way to obtain written consent from members.
In an effort to streamline the process, the Department, Managed Care Organizations (MCOs), and dental carriers are now utilizing form
470-5526, Authorized Representative for Managed Care Appeals, to obtain the member's consent.
Form
470-5526 will be used to appoint an individual, organization or provider to act on behalf of the
hawk-i member during the appeals process. This form should be completed by the
hawk-i member or their parent or guardian, if applicable.
This form will be used for the MCOs' and dental carriers' first level appeals process and the Department's state fair hearing process.
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Outreach Coordinator Assists Family with Dental Coverage
Parents of two children were very grateful for the recent help of a hawk-i outreach coordinator in assisting with dental coverage for their children.
During a conversation with the children's mother, I-Smile Program staff was made aware that the children had private health coverage, but no dental coverage. The family had been paying out-of-pocket for dental expenses and didn't know there was a dental coverage option through hawk-i . Both parents work, but the family couldn't afford the high cost of the dental services.
The children had multiple cavities scheduled to be filled the following week. Due to the family living out of town, the hawk-i outreach coordinator assisted them with completion of a presumptive eligibility (PE) application by email and fax. Both children were approved.
There was a concern that the dental office may not accept the PE coverage as they weren't accepting Medicaid patients at that time. The outreach coordinator called the dental office on behalf of the family, to explain PE and hawk-i dental. The dental office agreed to accept the PE since the children were established patients. The parents were very grateful for the help of the hawk-i outreach coordinator.
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Outreach Coordinator Secures Medical Benefits for Newborn with Special Needs
A hawk-i outreach coordinator successfully secured medical benefits for newborn twins, one of which had special needs.
One of the twins was born with Down syndrome. At the time of delivery, the infants did not have health coverage.
The mom was panicked stricken in not knowing how she would be able to afford the costs of helping her baby with his special needs.
By applying for PE, the hawk-i outreach coordinator was able to secure medical coverage for the twins. The Mom's stress level was relieved immediately with the knowledge that her baby's conditions would be met without the financial burden placed directly on her family.
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How Much Does hawk-i Coverage Cost?
The amount you pay for your child's coverage in the hawk-i program is based on your family's income. Some families pay between $10 and $40 a month for their hawk-i coverage. And depending on your family income level, some families may even pay nothing at all. No family pays more than $40 a month, even if the family has several children who qualify for hawk-i.
See the updated 2018 income guidelines here.
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Learn More About the hawk-i Board
The
hawk-i Board is a group of people and directors of other state agencies who are appointed by the Governor or who are members of the Legislature.
The Board was established to provide direction to the Iowa Department of Human Services (DHS) on the development, implementation, and ongoing administration of the
hawk-i
program.
The Board is required by law to meet at least six times per year and usually meets on the third Monday of every other month.
Most meetings are scheduled from 12:30 p.m. to 2:30 p.m. at the State of Iowa Historical Building, 600 E. Locust St., Des Moines, IA 50319.
To learn more click here.
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Board Meeting Schedule: 2018
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Looking for an Old Issue of the hawk-i 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
hawk-i resources
page
where you'll find links to each issue.
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IA Health Link Success Stories
IA Health Link is a managed care program that works to make sure members get the health care that they need. Click the
image
below to read the success stories.
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MCO Member Services:
1-800-600-4441
1-800-464-9484
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