September 6, 2019  |  Issue 11  |  Volume 4

Medicaid e-News
News and Announcements:
Member Open Choice Period Ends September 30, 2019
All members in the IA Health Link and Hawki programs are in an Open Choice Period through September 30, 2019. 

This means members may change their Managed Care Organization (MCO) for any reason during this time. MCO choices made by September 18, 2019 will be for coverage effective October 1, 2019; MCO choices made between September 19, 2019 through September 30, 2019 will be for coverage effective November 1, 2019.

Starting October 1, 2019, members will only be able to change MCOs during their annual choice period or for reasons of Good Cause.

To change your MCO, contact IME Member Services at 1-800-338-8366.

Iowa Total Care Providers
Since going live on July 1, 2019, new MCO Iowa Total Care has paid more than 220,000 total claims from all Medicaid provider types totaling over $50 million.

Providers who are having claims issues should contact Iowa Total Care Provider Services at 1-833-404-1061.

Reminders:
Continuity of Care: Community-Based Case Managers
DHS knows a member's relationship with their Community-Based Case Manager (CBCM) is important and wants to ensure continuity of care for members as they transition to a new MCO.

CBCMs help Long-Term Services and Supports members manage their complex health care needs. This includes planning, facilitating and advocating to meet the member's needs. CBCMs make sure that a member's care plan is carried out and they make updates to a member's care plan as needed. 

IME Member Services has a list of CBCMs hired by both Amerigroup Iowa and Iowa Total Care. This list is updated weekly. Members who wish to maintain their CBCM may contact IME Member Services, at 1 -800-338-8366, to find which MCO their CBCM is working for, if applicable.

Amerigroup Iowa and Iowa Total Care will work to maintain the member's same CBCM whenever possible.

Only the member, or an authorized representative of the member, should inquire about where a case manager is going.

IME Member Services will have the CBCM rosters available through September 30, 2019, which coincides with the conclusion of the member Open Choice Period.

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. 

If you currently do not have access to the ELVS web portal, you can register your provider at https://connect.edissweb.com. Each additional user that would like access to the provider's information can complete an Additional Access Request Form. If you have any questions regarding EDISS registration, call 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:


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

1-800-600-4441

1-833-404-1061

1-800-464-9484
PROVIDER SERVICES

1-800-454-3730

1-833-404-1061

1-888-650-3462

Dental Wellness Plan Contacts
MEMBER SERVICES

1-888-472-2793

1-855-247-6262
PROVIDER SERVICES

1-888-472-1205

1-855-856-6262

Iowa Medicaid Contacts
1-800-338-8366

PROVIDER SERVICES

1-800-338-7909

Success Stories
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 above to read success stories.
 


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