On Friday May 27, Gov. Branstad signed into law every additional Medicaid Modernization oversight item contained in the bi-partisan legislation, House File 2460. By signing into law every Medicaid Modernization oversight item, Iowa’s Medicaid program will be one of the most transparent, outcome-focused, and accountable programs in the country.
Below are various first-hand accounts from Iowa Medicaid providers’ experiences under Medicaid Modernization:
Success Story #1: Tanager Place (Cedar Rapids)
Amerigroup Iowa, Inc.
Tanager Place is a prevention, treatment and research center in Cedar Rapids that works with thousands of children and families who cope with mental and behavioral health challenges. They serve children from birth to age 18 by providing services such as outpatient clinic, art therapy, pediatric integrated health, Autism Spectrum Disorder, psychiatric inpatient programs and more. They have contracted with Amerigroup Iowa to serve some of their most vulnerable young members.
Most transitions, with new methods and processes, have hurdles to overcome and issues to work out. Through this process Amerigroup and Tanager Place remain in constant communication and ongoing collaboration.
According to Tanager Place, Amerigroup has gone above and beyond to answer questions and keep them informed of updates on systems configurations to ensure service authorizations and claims are being processed correctly and on time. Tanager Place recently reached out to Amerigroup to thank them for their knowledge and support, saying “We appreciate the effort to provide good customer service and look forward to a productive partnership.” Tanager Place praised Amerigroup for being helpful and responsive to their needs, as well as being positive and friendly.
Success Story #2: Iowa Association of Community Providers
Amerigroup Iowa, Inc.
The Iowa Association of Community Providers (IACP) is a group of more than 135 community-based organizations that provide services to children and adults with mental illness and mental health issues. Collectively the IACP association of providers serves more than 140,000 Iowans with disabilities. This organization has formed a highly collaborative partnership with Amerigroup Iowa.
Together, the two organizations have been coordinating learning sessions to teach IACP association providers how to use electronic systems to work with Amerigroup. They have arranged several online training courses that are interactive, conducted in real-time and teach providers how to navigate systems to submit claims, pre-authorization requests and more.
The IACP has commended Amerigroup for being easy to do business with. Many of the association members are not tech-savvy, and some do not have a lot of experience with electronic health records. In response, Amerigroup has customized training to meet their needs. The IACP has acknowledged Amerigroup for being responsive, understanding and accommodating. IACP members have thanked Amerigroup, saying their providers’ needs are being heard and Amerigroup has been effective in addressing those needs.
Success Story #3: Todd Seifert, M.S. (DeWitt)
Executive Director, DAC, Inc.
AmeriHealth Caritas, Iowa Inc.
Todd Seifert, M.S., is the executive director of DAC, Inc., a provider of community-based services, vocational programs and other services to Iowans with disabilities. Seifert shared his organization’s experience working with AmeriHealth Caritas Iowa.
“DAC has been extremely impressed with AmeriHealth Caritas Iowa’s communication throughout this IA Health Link transition,” said Seifert. “From our first meeting, AmeriHealth Caritas Iowa was willing to listen and work with us to meet our needs. We requested several meetings with AmeriHealth Caritas Iowa, and in all cases they sent professional staff who were able to answer all our questions or follow up and get us answers in a timely manner.
“I have spoken to several Executive Directors throughout the state about the transition and without fail everyone expressed their satisfaction with how AmeriHealth Caritas Iowa worked with them throughout the transition,” Seifert continued. “AmeriHealth Caritas Iowa’s desire to work with DAC and other providers has made this transition much easier to navigate.”
Success Story #4: Jane Hansen (Ottumwa)
Billing Manager, American Home Finding Association
AmeriHealth Caritas, Iowa Inc.
American Home Finding Association is a non-profit organization in Ottumwa which has been in business since 1899 and provides a variety of children and family services.
American Home Finding Association reports that its experience with AmeriHealth Caritas Iowa has been very positive. It credits Mary Brandt, AmeriHealth Caritas Iowa’s provider network account executive in the Ottumwa area, who has been very helpful and responsive to their questions.
Jane Hansen, the billing manager for American Home Finding Association, says AmeriHealth Caritas Iowa’s provider network management and prior authorization departments have been friendly and supportive. When there have been problems, Mary Brandt has helped find solutions to quickly resolve the issue.
Success Story #5: Maria Braden (Des Moines)
Pharmacy Manager, Wal-Mart Pharmacy #1723
United Healthcare Plan of the River Valley
Maria Braden, a Walmart pharmacy manager from Des Moines is pleased with UnitedHealthcare Plan of the River Valley, Inc.’s (UnitedHealthcare’s) commitment to ensure a smooth transition to the IA Health Link managed care program.
Braden recently wrote to UnitedHealthcare to thank them and offer perspective.
“Thanks so much for visiting our pharmacy with your community outreach project! I wanted to take a moment to thank you and your team at UnitedHealthcare. I went through a Medicaid transition in Florida with another company and it was a disaster. I was dreading the day of transition for Medicaid here in Iowa. That said, all the worry was for naught. We were very pleasantly surprised with the seamless transition that occurred for our UnitedHealthcare patients. We were supplied with all the needed billing information prior to the start date which helped a great deal. We do not feel that patient care was impacted at all through this transition. In addition, it appeared that all patients received their new cards prior to the start date. This speaks volumes to the dedication and attention to detail that the UnitedHealthcare team gave this project. Thank you so much for this very successful and stress-free transition. It was so greatly appreciated.”
Success Story #6: Lisa Eastman, MS, Administrator (Red Oak)
Red Oak Healthcare Community by Welcov Healthcare
United Healthcare Plan of the River Valley
UnitedHealthcare’s community outreach and customer service teams worked together to deliver a positive experience for Lisa Eastman, a health care administrator, and her sister, a UnitedHealthcare member. Lisa’s sister had been identified as high-risk, and UnitedHealthcare learned she had run into issues with getting her prescriptions in a timely manner.
In response, UnitedHealthcare’s customer service team has been working closely with Lisa to ensure her sister’s prescriptions arrive on time, and has worked to help make the process as hassle-free as possible. Lisa is happy to share her family’s story in the hopes that it will help calm fears relating to the transition to managed care.
“I appreciate the extra effort from the UnitedHealthcare team to assist my sister and minimize her frustrations. When she had to select her provider I recommended UnitedHealthcare for this very reason—I knew they would be able to manage her unique medical circumstances.”
My wife is a nurse at a nursing home and she says there are now all kinds of problems and people withuot any coverage.
The transition to privatized Medicaid has been anything but smooth ! I work in a medical office, business dept., and claims have been rejected for no reasons, other than to delay payments ! Ameri-Health & Ameri-Group are difficult companies to work with. United Healthcare is on the way out. Amanda Ragan has been helpful to a degree, but the transition is FAR from smooth. Lots of Medicaid patients still DO NOT have their new cards…..smooth transition , huh? Not really
I have several friends who would dispute the Gov’s crowing. Two of them have children with disabilities and their experience with finding providers and having a convenient place to go for treatment and/or a provider is disheartening and certainly in opposition with this article. Note that their are no direct statements from people who have to deal with this, just care givers and organizations who have benefitted from the transition. Terry won’t address the problems and pushes them under the carpet.