September 10, 2018  |  Issue 22  |  Volume 3
Medicaid e-News
News and Announcements:
Annual Dental Benefit Maximum Effective September 1, 2018

Effective September 1, 2018, every Medicaid member, age 21 and older, has a $1,000 annual benefit maximum (ABM) for dental services each State Fiscal Year (July 1 - June 30).

Preventive, diagnostic or emergency dental services, anesthesia in conjunction with approved oral surgery procedures, and fabrication of dentures do not count toward a member's ABM. Examples of dental services that do not count toward a member's ABM include: exams, cleanings, x-rays, and fluoride.

The Iowa Medicaid Enterprise (IME) has created a process for a daily file exchange of claim information between the dental benefit administrators - Delta Dental and MCNA - to track the ABM of members enrolled in the Dental Wellness Plan. This allows dental benefit administrators to have reliable ABM amounts that can accurately be shared with members and providers.

Members can contact their dental provider to receive an estimate of what their remaining ABM is. This is only an estimate as processing of a member's recent dental services may still be pending.

Providers may view ABM information by calling the Eligibility and Verification Information System (ELVS) line at 800-338-7752 or by accessing the ELVS web portal.

For more information, see  Informational Letter 1941.



University of Iowa College of Dentistry Now Accepting New Medicaid Members

The University of Iowa College of Dentistry has informed the IME that they are once again accepting new Dental Wellness Plan (DWP) patients into their student clinics.

The College of Dentistry had placed a hold on accepting new DWP patients over the summer as they worked with IME staff and the dental benefit administrators - Delta Dental and MCNA - to ensure they would be able to determine a DWP member's remaining annual benefit maximum for dental services.

Request for Information on EVV Program

The Department is seeking information and feedback from vendors, stakeholders, managed care organizations, members and constituents on the Electronic Visit Verification (EVV) program.

The Department is receiving responses until 3 p.m. September 28, 2018. Written responses must be submitted via email to [email protected].

Public Notices

The following public notices and requests for comment have recently been posted on the Department's website:



Inpatient Hospital Rate Rebase/Diagnosis Related Group Weight Recalibration
Reminders:
Good Cause
Remember, members  requesting to change their MCO due to 'Good Cause,' f irst must contact their current MCO to go through their grievance process for resolution. If the issue has not been resolved following the decision of the grievance, the member may call Iowa Medicaid Member Services. The final decision for disenrollment will be determined by DHS. For more information click here.

Provider Tools and Resources:
Providers are Encouraged to 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. 
 
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:


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.



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.

Iowa Medicaid Contacts
Iowa Medicaid Provider Services
1-800-338-7909
IA Health Link Member Services
1-800-600-4441

1-800-464-9484
IA Health Link Provider Services
1-800-454-3730

1-888-650-3462
Dental Wellness Plan Member Services
1-888-472-2793

1-855-247-6262
Dental Wellness Plan Provider Services
1-888-472-1205

1-855-856-6262

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. 

Iowa Medicaid Enterprise | [email protected] | dhs.iowa.gov
100 Army Post Rd., Des Moines, IA 50315
Copyright © 2018. All Rights Reserved.
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.