Welcome to the Iowa Medicaid Enterprise Provider Website!

 

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!

2009 Flu Vaccine Update

The IME will pay for administration of the regular flu shots for all covered Medicaid members when the vaccine is covered under the VFC program. The vaccine and administration codes will be the same as in prior years. The vaccine and administration is also covered for all those where the VFC program does not apply. This year all people are encouraged to receive the regular flu vaccine and to receive it early. H1N1 vaccine will be free to all providers; questions about vaccine distribution and availability should be addressed to the Iowa Department of Public Health. The IME is responsible for the administration charges for vaccines given to Iowa Medicaid members. Payment for the following codes for the H1N1 vaccine and administration will be allowed; the G codes are the same codes used by Medicare.

  • G9142 with a $0.00 charge for the vaccine
  • G9141 for the administration (or the IME will pay another appropriate vaccine administration code)
  • The vaccine code must be billed with the administration code in order for the administration code to be payable.

Important Provider Announcements

Important Critical Incident Report News and Resources

Online Training Modules for Provider Annual Training 2009

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 515-725-1004.

 

All Claim Instructions and Forms

Crossover Claims

CMS-1500 Claims

UB04 Claims

ADA 2006 Claims

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.


            

     

     

     

    Provider Tools and Resources

  • NEW! Dentist Accepting Clients
  • EDISS(Electronic Data Interchange)
  • ELVS (Eligibility and Verification
         Information System)
  • I-MERS (Iowa - Medicaid 
         Electronic Records System)
  • Provider Web Portal Services
  • Search for a Provider
  • Quick Links 

  • Additional ASC procedure codes
  • All Multiple Source NDC Codes - Not Top 20
  • Appeals Process
  • CDAC Information
  • Deficit Reduction Act of 2005 - Section 6032
  • Emergency Diagnosis Codes
  • EOB Crosswalk
  • Informational Letter #807
  • Iowa Medicaid Care Management
  • Iowa Medicaid Enterprise
  • Iowa Medicaid Pharmaceutical Care Management
  • ImeServices
  • Key Elements of I-MERS
  • Lock-In
  • Level of Care Process
  • MAAC
  • PACE
  • PC-Ace Pro32 Instructions
  • Pharmacy POS
  • Preferred Diabetic Monitors and Test Strips List
  • Rebatable Drug List for J-Code Billing
  • TCM Cover Form
  • SMAC - State Maximum Allowable Cost Program
  • TCM Through the ISIS System
  • Terms and Conditions
        (Amended 4/26/07)
  • Provider Notices

  • Deficit Reduction Act of 2005 - Section 6032

  • CMHC Public Notice

  • IP Hospital Psych Public Notice

  • OP Hospital APC Public Notice
  • Providers who submit EMC claims, please click HERE for current updates.

     


    Operating Hours and
    Contact Number
     

    1-800-338-7909
    or
    (515)725-1004

    (Local)

    Customer Service

    (Option 1)
    Monday to Friday
    7:30 am to 4:30 pm

    Provider Enrollment 
    (Option2)
    Monday to Friday
    7:30 am to 4:30 pm

    E-Mail Us 
    (Please remember to include NPI)


    ELVS
    (Eligibility Verification System)

    24 hours a Day/7 Days a Week

    Toll Free
    800-338-7752

    Local
    515-323-9639

     

     

     


     

     

    Images of people and children