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The waiting period for Medicaid approval in Iowa is an integral part of the application process. After submitting your application, the Department of Human Services (DHS) will typically take about 30 to 45 days to process your application, although the timeframe can vary.
Medicare Advantage (MA) plans also often require prior authorization to see specialists, get out-of-network care, get non-emergency hospital care, and more. Each MA plan has different requirements, so MA enrollees should contact their plan to ask when/if prior authorization is needed.
Iowa Total Care uses prior authorizations to ensure that all care delivered to our members is medically necessary and appropriate based on the members type and severity of condition.
Fax: Home health, durable medical equipment, therapies and discharge planning: 1-888-235-8468.
Apply for Medicaid in Iowa Eligibility: Children up to age 1 with family income up to 375% of FPL. Children ages 1 to 18 with family income up to 167% of FPL; children with family income up to 302% of FPL may qualify for the hawk-i program. Pregnant women with family income up to 375% of FPL.
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Amerigroup follows the timely filing standard of 365 days for participating and nonparticipating providers and facilities. Timely filing is determined by subtracting the date of service from the date Amerigroup receives the claim and comparing the number of days to the applicable federal or state mandate.
All Claim Payment Appeals must be submitted in writing or via our provider website. We accept web and written payment Claim Payment Appeals within 60 calendar days of the date the Reconsideration Determination letter was mailed.
Prior authorization is required for certain services and supplies. Submission of a prior authorization request form along with all supporting documentation is necessary to obtain these services and/or supplies: Durable Medical Equipment (DME) - Augmentative, Vision, Hearing. DME Rental.

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