Medical billing services in Iowa
Billing, coding, credentialing and A/R follow-up for providers in Iowa.
Billing in Iowa: what is different
IA Health Link managed care plans serve most Iowa Medicaid members.
Key payers and contractors in Iowa
- Medicare Part A/B
- WPS Government Health Administrators, Jurisdiction J5Portal: WPS GHA Portal
- Medicare DME
- Noridian, DME MAC Jurisdiction DDME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- Iowa Medicaid (IA Health Link)
- Blue Cross Blue Shield
- Wellmark Blue Cross and Blue Shield
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Iowa providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with WPS Government Health Administrators through the WPS GHA Portal
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Iowa: common questions
Do you bill Iowa Medicaid and its managed care plans?
Yes. We bill Iowa Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Iowa?
Medicare Part A and B claims in Iowa are processed by WPS Government Health Administrators (Jurisdiction J5), and we submit and track them through the WPS GHA Portal. DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction D), through the Noridian Medicare Portal (NMP).
Can you credential new providers in Iowa?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Iowa.
Neighboring states and key payers
Get a free billing audit for your Iowa practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.