Claims Processing and Reimbursement

Care for Yourself Breast and Cervical Cancer and WISEWOMAN Program

Medical Billing Services (MBS) processes and reimburses claims for the Breast and Cervical Cancer Program and the WISEWOMAN Program. All reimbursements for the Breast and Cervical Cancer Program and the WISEWOMAN Program will by paid by MBS doing business as "Iowa Screening Programs." Questions regarding claims should be directed to MBS at 515-412-2815 or iowascreening@practisynergy.com.

Claims may be submitted to:

Medical Billing Services
Attn: Iowa Screening Programs
500 East Court Avenue
Suite 305
Des Moines, IA 50309-3974

Timely Claims Submission

Reimbursement of claims will be processed up to one year (12 months) from the date of service. Claims exceeding the 12-month period from the date of service will be denied. No participant should be billed for any covered service denied due to not filing a claim in a timely fashion.

Payor of Last Resort

As a reminder, no participant should be billed for any covered service. The participant must be made aware before the service is provided that the screening program will not cover the procedure and that the cost will be the participant's responsibility.

If the participant has insurance, an Explanation of Benefits (EOB) must be obtained from an insurance company and submitted with the claim. The BCC program will reimburse for copay and deductibles up to the amount indicated on the BCC Program Reimbursement Schedule for the portion not covered by insurance.

An individual enrolled in the BCC program should not be billed for:

Any program-covered service.
Claims denied for not filing in a timely manner.
Collection and transportation of specimens. These costs are to be covered by the office visit reimbursement. They should not be billed separately.

Resubmission of Claims

If a previously denied claim is being submitted for payment, a notation of *Corrected Claim* must be at the top of the claim form for proper processing. If this is not done, the claim will be denied as a duplicate.