Prior Authorization in Iowa
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Iowa practices and billing companies at $1,800 per seat per month. Full time, worked during Iowa business hours, inside your own system.
What is specific to Iowa
Nearly all Iowa Medicaid members are enrolled with a small number of managed care organizations under IA Health Link, and Wellmark Blue Cross Blue Shield is the dominant commercial carrier statewide.
Iowa’s Medicaid programme is Iowa Medicaid (IA Health Link). Practices with a meaningful Iowa Medicaid (IA Health Link) mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a prior authorization seat does in Iowa
Submitted before the date of service and chased through the payer's decision window.
An authorisation found after the visit is a write-off, not a denial to appeal. In Iowa the work is submitting ahead of scheduling and chasing the decision, against a payment clock that starts only once a clean claim lands.
- Authorizations submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when required
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Worked during Iowa business hours, not queued overnight
For the statute behind all of this — Iowa’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Iowa billing page.
Working Iowa hours
Iowa runs on Central time, 11 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 8pm to 4am, and 7pm to 3am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Iowa hours and nobody else’s.
What it costs in Iowa
$1,800
Per seat, per month, in US dollars — $21,600 a year for one full-time person, forty hours a week, on Iowa hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Iowa run $1,450 to $2,400; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Iowa
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with Iowa practices?
Yes. Iowa accounts are worked during Iowa office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Iowa?
Nearly all Iowa Medicaid members are enrolled with a small number of managed care organizations under IA Health Link, and Wellmark Blue Cross Blue Shield is the dominant commercial carrier statewide.
How long do we have to file a Iowa Medicaid (IA Health Link) claim?
365 days from the date of service, measured from the date of service. Resubmit or adjust within 365 days of the last adjudication (the remittance date of denial), never beyond two years from the date of service. Past that date a claim is not late, it is unpayable, and no appeal recovers it. Source: Iowa HHS — All Providers, Chapter IV. Billing Iowa Medicaid (provider manual).
When does a Iowa payer have to pay a clean claim?
30 days for clean claims — no electronic vs. paper distinction (the statute, Iowa Code 507B.4A, sets no number itself; the 30-day deadline lives in the implementing rule, Iowa Admin. Code 191—15.32(2)(a)). Interest of 10% per annum accrues from the 31st day. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does prior authorization cost in Iowa?
$1,800 per seat per month — $21,600 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Iowa queue?
Iowa is on Central time, 11 hours behind Rawalpindi. The shift here runs 8pm to 4am so your seat is at a desk for your full working day, shifting to 7pm to 3am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Iowa Medicaid (IA Health Link) as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Iowa Medicaid (IA Health Link) has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Iowa work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com