November 15, 2018 | Issue 34 | Volume 3
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Why Did I Receive A Bill For $3?
Adult Iowa Medic
aid members that have received a monthly bill in the mail for $3 have not met the requirements of the Dental Wellness Plan.
To keep full dental benefits and pay no monthly premiums, members must complete
"
Healthy Behaviors
" during each enrollment year.
Healthy Behaviors include the completion of both:
- Oral Health Self-Assessment and
- Dental Preventive Service
If members do not complete their Healthy Behaviors each year, they may be charged a $3 monthly premium.
If a member receives a bill and does not pay it for more than 90 days, they will be moved to basic dental benefits. The Department of Human Services (DHS) will notify affected members by mail of this decision.
More information about the Healthy Behaviors requirements for dental can be found on the
DHS website
. Dental carriers
Delta Dental
and
MCNA Dental
also share information about Healthy Behaviors with their members.
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Payment Of Nursing Facility Room And Board Expenses Options Report
As part of a Legislative requirement, DHS recently submitted a report to the Iowa Legislature exploring options for possible elimination of room and board pass-through payments for the dually eligible Medicare and Medicaid beneficiaries receiving hospice benefits in a nursing facility. The report was submitted in compliance with 2018 Iowa Acts, House File 2309 which required DHS to consult with affected providers and stakeholders to pursue options to reimburse a nursing facility directly for this population.
The Department collected feedback from providers, hospice and nursing home association representatives, MCOs and other stakeholders in drafting its report. The Department presented four options to the Legislature in its report, but did not give a recommendation for which option, if any, should be chosen.
The current process for pass-through remains in effect. Any potential change proposed by the Legislature would also need to be approved by the Centers for Medicare and Medicaid (CMS).
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Provider Training Update
The IME is working with the three Managed Care Organizations (MCO) - Amerigroup, UnitedHealthcare and new MCO Iowa Total Care - on developing more specialized training events in 2019.
The IME collected feedback from providers in July regarding the annual provider training and intends to include many of the suggestions. The IME and the MCOs are also researching the possibility of offering online training opportunities in 2019 in addition to the face-to-face sessions.
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Public Notices
The following public notice and request for comment has recently been posted on the Department's website:
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DHS Now Accepting Medicaid Premiums Online
Iowa Health and Wellness Plan members and Dental Wellness Plan members that receive a monthly billing statement in the mail, can now pay their premiums online.
Payments may only be made from your checking or savings account. Once you submit your payment information, a receipt will be made for your records.
The ClickPay website does not require you to create an account to make a payment. However, you'll need to enter your statement number, Member ID and the last 4 digits of your Social Security Number to make a payment. (The statement number is located on the front of the statement, in the upper-right-hand corner.)
Once you enter the required information you will be transferred to a secure bank site: U.S. Bank, to complete your transaction. U.S. Bank processes the premiums for DHS; you do not need to have a U.S. Bank account to pay your contribution online.
The ClickPay online payment option is not available for
hawk-i or Medicaid for Employed People with Disabilities members.
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Changing Your MCO
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 at 1-800-338-8366. The final decision for disenrollment will be determined by DHS. For more information click here.
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Provider Tools and Resources:
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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.
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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:
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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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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.
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IA Health Link Member Services
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1-800-600-4441
1-800-464-9484
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IA Health Link Provider Services
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1-800-454-3730
1-888-650-3462
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Dental Wellness Plan Member Services
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Dental Wellness Plan Provider Services
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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.
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Follow Us!
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100 Army Post Rd., Des Moines, IA 50315
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Copyright © 2018. All Rights Reserved.
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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.
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