Referral

IA Health Link

Medicaid Managed Care

On April 1, 2016, the Iowa Department of Human Services transitioned most Iowa Medicaid members to a managed care program called IA Health Link. Most Iowa Medicaid members are enrolled in IA Health Link, which provides coverage through two managed care organizations (MCOs). Providers who care for Medicaid members must contract with the MCOs.

Medical group

EPSDT Care for Kids

EPSDT Care for Kids is Iowa's Early and Periodic, Screening, Diagnosis and Treatment program for children who are enrolled in Medicaid. Care for Kids services are free to children enrolled in Medicaid. EPSDT services include:

  • health history
  • physical exam
  • growth and development assessment
  • vision and hearing screening
  • dental screening and education
  • immunizations
  • developmental/behavioral screening
  • nutrition assessment and education
  • laboratory tests including blood lead testing
  • anticipatory guidance
  • referral for further diagnostic and treatment services

The EPSDT Care for Kids Informing and Care Coordination Handbook is available online.

Prior Authorization

Amerigroup

Amerigroup Medical Management:

UnitedHealthcare

Important Notice

Amerigroup Iowa has been building its capacity to take on new IA Health Link members since the withdrawal of AmeriHealth from the state's managed care program last fall. Members, who were temporarily transitioned to Fee-for-Service at that time, began coverage with Amerigroup on March 1, 2018. New members, whose effective date of coverage begins May 1, 2018 or later, will be able to choose Amerigroup or UnitedHealthcare. For more information, see the IA Health Link FAQs for Members and FAQs for Providers.

Contact the MCOs

Amerigroup

Amerigroup Iowa, Inc.

Email:
iowamedicaid@amerigroup.com

Phone:
1-800-454-3730

Website:
https://providers.amerigroup.com/ia

UnitedHealthcare

UnitedHealthcare of the River Valley, Inc.

Email:
IowaCommunityNetwork@uhc.com

Phone:
1-888-650-3462

Website:
http://www.uhccommunityplan.com/health-professionals/ia.html

AmeriHealth Caritas

AmeriHealth Caritas Iowa, Inc.

Email:
IowaProviderNetwork@amerihealthcaritas.com

Phone:
1-844-411-0579

Website:
www.amerihealthcaritasia.com/IAProvider

AmeriHealth Caritas Iowa, Inc. withdrew from Iowa's Medicaid managed care program on November 30, 2017. Use this information to contact them regarding services provided through the withdrawal date.

AmeriHealth Caritas Provider Handbook:

  • Section VI: Grievances, Appeals and Fair Hearings

DHS Medicaid Tools

Providers should continue to use the eligibility tools from the Iowa Department of Human Services (DHS) to determine a member's MCO enrollment. Link to Medicaid Tools for Providers on the DHS website.

Grievances and Appeals

Providers may file claim disputes with the managed care organizations (MCOs). Each of the three MCOs has developed and implemented written policies and procedures for claim disputes. You will find information about their grievances and appeals policies and procedures in their provider handbook or manual. Link to these online:

Amerigroup Provider Handbook:

  • Chapter 14: Grievances and Appeals

UnitedHealthcare Provider Manual:

  • Chapter 4: Grievances, Appeals and State Fair Hearings

Contact Us

If you have questions or would like information related to specific services or topics, please visit our Contact Us page.

If you prefer to get in touch with EPSDT Care for Kids by phone, please use this number:

Telephone: 319-384-5656

Website Accessibility

EPSDT is committed to making all information and materials accessible to everyone.

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