August 11, 2017  |  Issue 13  |  Volume 2
Medicaid e-News
Announcements: 
Iowa Medicaid Members' Satisfaction Ranks Second Highest in Nation
Iowa Medicaid members' satisfaction with the state's IA Health Link managed care program ranks second highest in the nation, according to results released by JD Power, a global market research company.

The results also show that Medicaid members in Iowa, Tennessee, Arizona and Indiana have the easiest access to doctors and hospitals, compared with other states included in the report.

JD Power surveyed 36 states and Washington, D.C. from January-March 2017. The company rated overall satisfaction with managed Medicaid programs using six criteria: provider choice, coverage and benefits, customer service, cost, information and communication and claims processing.

Gov. Kim Reynolds' press release can be found here.

More findings from the JD Power report can be found  here.
 
Provider Re-enrollment
The deadline for provider re-enrollment was June 30, 2017. There are a number of providers who have failed to complete the re-enrollment process.
 
The Iowa Medicaid Enterprise (IME) is actively working to ensure providers complete re-enrollment in compliance with federal regulations, while also minimizing any disruptions to the payment or delivery of services. 

Final notices will be sent to two groups of providers based on claims history:
  • Providers who have not submitted claims in calendar year 2017
  • Providers who have submitted claims in calendar year 2017
Providers with questions regarding re-enrollment should call IME Provider Services at 
1-800-338-7909.
 
Annual Provider Training is Coming...
Look for an announcement soon with dates, locations and topics for the 2017 Annual Provider Training. Once again, these training sessions will be facilitated by the Iowa Medicaid Enterprise (IME) and will have representatives from the three Managed Care Organizations (MCOs) present.
 
Success Story: 
IA Health Link Member Develops a New Outlook on Life
An AmeriHealth Caritas member had fallen on hard times. He had multiple health conditions and a drug addiction, but was earning a living driving a truck. His trucking route gave him easy access to narcotics and, over the last several years, his addiction became increasingly severe.
 
In August, he had a heart attack and spent several days in an intensive care unit. He became depressed and returned to regular drug use once he was released. At his lowest point, he contemplated suicide.
 
At the same time, he began working with his case manager, an AmeriHealth Caritas Iowa behavioral health specialist. His case manager listened to him and helped him put together a plan to get his life back on track.  His case manager helped him come to terms with his addiction and face the road to recovery. She connected him with the resources he needed to make changes in his life.
 
"I knew [he] needed to make lifestyle changes if he was going to be successful," his case manager said. "At first, I suggested walking, but [he] couldn't walk farther than half of a block. He didn't enjoy it and couldn't make it part of his routine." They discussed ways he could become healthier and change his habits. Soon after, he found Daisy, a young dog who requires daily walks, which helped to make walking part of his routine.
 
His case manager helped him find doctors and connected him with AmeriHealth Caritas Iowa's pilot telehealth program for members with congestive heart failure. The pilot program provides members with smartphones, blood pressure cuffs, and scales to monitor their health data with the help of a health coach. He began losing weight, relying on his support system, and consistently taking his medication. He gained a positive outlook on his health and future.
 
Today, this AmeriHealth Caritas member and Daisy, his dog, walk up to seven miles each day and he plans to retire from trucking next month. He is drug-free and continues to work with his case manager

Provider Tools and Resources:
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.

Member Services
Provider Services
Iowa Medicaid Provider Services
1-800-338-7909

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