Reimbursement ARCHIVE
Find the reimbursement information and tools you need to be successful.
For more information on reimbursement resources, contact Brandon Hagen.
Can’t find what you are looking for here? Try our Search function on the home page of our website to search past IHCA Bulletin articles.
Skilled Nursing FacilitiesAHCA NCAL Ed – Population Health Management Innovation Lab
Medicaid
Application Process
- Unmet Medical Need Request (spreadsheet)
- Medicaid documents for skilled nursing facilities (DHS)
- How to Apply for Nursing Facility Medicaid (DHS)
DHS Employee Manual
Payment
Provider Manual
Provider Resources
- LEIE Downloadable Databases
- Census/CMI and RUG Distribution Summary Data
- Medicaid Tools for Providers (DHS)
- Subscribe to E-delivery of Informational Letters
- Iowa Medicaid Informational Letters
- Managed Care Medicaid Provider Informational (DHS)
- Iowa Health Link – Department of Human Services (DHS)
- CMS Website: Institutional Long-Term Care (Medicaid.gov)
Quality Assurance Assessment Fee (QAAF)
- Quality Assurance Assessment Fee Informational Letter No. 2008-MC-FFS
- Quality Assurance Assessment Fee Calculator
- Quality Assurance Assessment Fee 2019 Update
Regulations
Medicare
Medicaid
DHS Employee Manuals
- DHS Employee Manual- Medicaid Waiver Services
- DHS Employee Manual- HCBS
- DHS Employee Manual- Medicaid Provider
Housing Assistance
- Iowa Specific 2018
- Fair Market Rents - HUD
- HUD – Section 8 Fact Sheet
- Iowa Finance Authority rent subsidy
Payment
Provider Manuals
- Providers Manual Appendix
- DHS Provider Manuals
- Residential Care Facilities Provider Manual
- Managed Care Provider Resources (DHS)
- Elderly Waiver Provider Manual
- Information Packet and Instructions on How to Apply to be a Waiver Provider
Provider Resources
- LEIE Downloadable Databases
- Medicaid Documentation Tools (Assisted Living Partners)
- 2010 National Survey of Residential Care Facilities
- Iowa Medicaid Portal Access
- Medicaid Tools for Providers (DHS)
- Subscribe to E-delivery of Informational Letters
- Iowa Medicaid Informational Letters
- Managed Care Medicaid Provider Informational (DHS)
- Iowa Health Link - Department of Human Services (DHS)
- CMS Website: HCBS (Medicaid.gov)
Regulations
Medicaid
DHS Employee Manual
Payment
Provider Manual
Provider Resources
- LEIE Downloadable Databases
- Medicaid Tools for Providers (DHS)
- Subscribe to E-delivery of Informational Letters
- Iowa Medicaid Informational Letters
- Managed Care Medicaid Provider Informational (DHS)
- Iowa Health Link - Department of Human Services (DHS)
- CMS Website: HCBS (Medicaid.gov)
Regulations
Medicare
PDGM Resources
- SE19025 – MLN Connects Special Edition – Instructions on How Register (iQIES)
- Overview of PDGM SE 19027 Physician
- SE19028: Payments and Payment Adjustments under the Patient-Driven Groupings Model
- PDGM Maze Made Easy by Your Documentation System
- MM11081: Home Health Patient-Driven Groupings Model (PDGM) — Split Implementation
- MM11272: Home Health Patient-Driven Groupings Model (PDGM) — Additional Manual Instructions
- MM11395: Home Health (HH) Patient-Driven Groupings Model (PDGM) — Revised and Additional Manual Instructions
- MM11527: Home Health (HH) Patient-Driven Groupings Model (PDGM) - Revised and Additional Manual Instructions
- Centers for Medicare & Medicaid Services Patient-Driven Groupings Model
- Home Health Agency (HHA) Center
- Z Codes in PDGM
- OASIS Considerations for PDGM Transition
- 2020 PDGM Final Dollars Case Weight
CGS Administrator
Amerigroup
How to enroll in the network
Provider resources
- Claim and Billing Reference Manual
- Patient360 web tool
- Remittance Viewer access instructions
- Claim Documentation Submission Availity Guide
- New Provider Orientation
- Provider Manual
Provider relations
- Manager of Case Managers
- Ancillary Provider Network Managers
- Amerigroup Provider Relations Consultants
Iowa Total Care
How to enroll in the network
Provider resources
Provider relations
- Coming Soon
United Healthcare
Provider resources
- Forms and Reference Guides
- Prior Authorization Information
- Claims and Payment Information
- Provider Manual
Provider advocate resources
- Behavioral Health Network Manager Map – Email iowa_behaviorialhealth_team@uhc.com
- Home and Community Based Services Provider Advocate map – Contact Provider Services at 888-650-3462 or email iowacommunitynetwork@uhc.com
- In-Network Provider Lookup
- Physician/Ancillary Advocate Map – Email iowa_pr_team@uhc.com
- Skilled Nursing Facility/Nursing Facility Advocate Map – Email ccm_ia_pra_optum.com
Manager of Case Manager information
- Contact Provider Services at 888-650-3462