Iowa Department of Human Services

Welcome to the Iowa Medicaid Enterprise Provider Website!

The Iowa Medicaid Enterprise Phone Numbers are changing

Effective January 25, 2010 please use the updated phone list when contacting the IME.

The Iowa Medicaid Enterprise (IME) relies on dedicated providers like you to serve the health care needs of members of Iowa's Medicaid program. By participating in Iowa Medicaid you are joining a network of providers throughout the State whose efforts and commitment have resulted in a significant increase in the number of Iowa families who have access to appropriate health care. Without the participation of providers like you, this program would not be possible!

Important Provider Announcements

Rule changes to achieve savings required by Executive Order 19

Important Correct Coding Initiative Announcement

Iowa Medicaid Health Information Technology (HIT) Activities

Printable version of IDPH HIT Survey

Peer-to-Peer Conversation

Important Critical Incident Report News and Resources

Attention: This FORM CANNOT be used to make a report of child abuse or dependent adult abuse. Report of suspected child abuse and dependent abuse shall be made by calling the Abuse hotline 1-800-362-2178.

Second Incident Reporting Notice for Habilitation Providers and HCBS Waiver Providers
Critical Incident Report form 470-4698 (Rev 9/09)

Critical Incident Report User Guide Form 470-4698

PORTAL to the Iowa Medicaid Provider Access: Critical Incident Report

Web Tutorial: Iowa Medicaid Provider Access-PortalCritical Incident Report

IMPA Case Management Business Process

Online Training Modules for Provider Annual Training 2009

Documentation Standards Annual Training 2009 Webinar

General Policies and Procedures Annual Training 2009 Webinar

Remedial Services Provider Training Webinar

IME Provider Training Online Evaluation and Suggestions Form

Click here to get information on how to enroll as a Medicaid Provider

Important Information Regarding Claims Forms
The claims forms provided on this website are for reference purposes only. In order to process claims, IME must have original versions of the forms. Please do not submit claims on the forms found on this website. Original versions of the CMS-1500, UB-04 and Dental Claim forms can be found at office supply stores. Originals of the Targeted Medical Care claim forms can be requested from IME by contacting Provider Services at 1-800-338-7909 or locally at 515-256-4609.

All Claim Instructions and Forms

Crossover Claims

^{_{Institutional Crossover Instructions}} - ^{_{[ 79kb]}}
^{_{Institutional Crossover Forms}} - ^{_{[ 776kb]}}
^{_{Professional Crossover Instructions}} - ^{_{[ 81kb]}}
^{_{Professional Crossover Forms}} - ^{_{[ 757kb]}}

CMS-1500 Claims

^{_{CMS-1500 Instructions}} - ^{_{[ 350kb]}}
^{_{CMS-1500 Sample Claim Form}} - ^{_{[ 350kb]}}

UB04 Claims

^{_{UB04 Instructions}}
^{_{UB04 Sample Claim Form}} - ^{_{[ 1,001kb]}}

ADA 2006 Claims

^{_{ADA 2006 Instruction}}
^{_{ADA 2006 Sample Claim Form}} - ^{_{[ 489kb]}}

Targeted Medical Care 470-2486 Claim

NEW!! - Fill out the waiver claim form using this easy template, print, and mail in!

Template for Targeted Medical Care, 470-2486

^{_{Template Instructions}}

Medicaid Policies

These manuals are the Department's official interpretation of the federal laws and regulations and the state laws and rules relating to the Medicaid program. Click on the books below to view the manuals.