Breast & Cervical Cancer - Claims Processing and Reimbursement

Medical Billing Services (MBS) processes and reimburses claims for the Breast and Cervical Cancer Program. All reimbursements for the Breast and Cervical Cancer Program will by paid by MBS doing business as "Iowa Screening Programs." 

Questions regarding claims should be directed to MBS at 515-412-2805 or iowascreening@practisynergy.com.

 Claims Submissions for CFY-BCC Services:

Paper claims submissions should be sent to:

Attn Nicole Wilson

Iowa Screening Programs 

PractiSynergy

Iowa Screening Programs

1501 50th Street, Suite 110

West Des Moines, Iowa 50266

Phone: 515-412-2805 

Fax: (888) 503-7693

Email: iowascreening@practisynergy.com

Electronic claims submissions are to be submitted electronically. MBS accepts 1500 claim forms electronically, but not UB claim forms. Provider clearing houses are to be provided with the following information:

• Professional Claims Payor ID # is HSMBS
• Professional Claims Relay Health – CPID # 7790
• Institutional Claims Payor ID # is USMBS

PractiSynergy/Medical Billing Services Contact Details

• Direct Phone: 515-412-2805
• The best point of contact for claim status is this email iowascreening@practisynergy.com.
• When leaving voicemails please ensure you include, your full name, your program/facility name and your phone number.

Requests for Updating or Adding a Healthcare Facility to the CFY-BCC Program

To request the addition or update of health care facility, email CareForYourself@hhs.iowa.gov and include the following information in your email:

1. Facility's full name
2. Facility's full address (number, street name, city, state, zip code)
3. Facility's contact person's name and email address

Please send your requests via email.

Timely Claims Submission

Reimbursement of claims for CFY-BCC Program services will only be processed for 180 days from the participant’s date of service. Claims will therefore need to be filed with PractiSynergy/MBS within 180 days from the participant’s date of service. Claims received after the filing deadline (exceeding the 180-day period from the date of service) will be denied for not being filed in a timely manner. Claims denied for late filing may not be billed to the program participant. 

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.