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Information for Healthcare Providers

Before You Get Started...

Health Care Providers

Please review the Care for Yourself program guide first to determine if the healthcare facility meets the program requirements.

If you have specific healthcare provider questions regarding the Care for Yourself program, please contact Gena Hodges (gena.hodges@idph.iowa.gov or 515-281-4909). Thank you for your partnership.

For 2017, CPT codes 77051, 77052, 77055, 77056 and 77057 have been deleted. These codes have been replaced with codes 77065, 77066 and 77067 combining the CAD and conventional mammogram as one payment. The payment for CAD has also been combined into the payment for the digital mammogram codes of G0202, G0204 and G0206

CFY - Breast and Cervical Cancer Program - Facility and Healthcare Provider Application

Thank you for your interest to enroll as a Corporation/Lead Facility for the Care for Yourself - Breast and Cervical Cancer Program, please review the Healthcare Facility and Healthcare Provider Guide prior to requesting any of the documents below.

The Breast and Cervical Cooperative Agreement is not effective until the document has been fully executed with signatures of both parties and received by the Corporation/Lead Facility. The fully executed agreement will be scanned and electronically sent back to the applicant.

To request a Cooperative Agreement and/or a facility enrollment application, please submit your request in an email to Gena.Hodges@idph.iowa.gov. The subject line should state “BCC Application”. The Corporation/Lead Facility Cooperative Agreement needs to be renewed every six years. For further questions and to see if your application is up to date, please contact Gena Hodges at Gena.Hodges@idph.iowa.gov or 515-281-4909.

  • BCC Cooperative Agreement - submit a request
  • BCC Application for Facilities and Healthcare Providers - submit a request 
  • W-9 Form  PDF

CFY- WISEWOMAN Program - Facility and Healthcare Provider Application

Thank you for your interest to enroll as a Corporation/Lead Facility for the Care for Yourself - WISEWOMAN Program. Please review the Healthcare Facility and Healthcare Provider Guide prior to completing the documents below. Approval to enroll in the WISEWOMAN Program is limited and pre-authorization to enroll as a Corporation/Lead Facility is required.

The WISEWOMAN Cooperative Agreement is not effective until the document has been fully executed with signatures of both parties and received by the Corporation/Lead Facility. The fully executed agreement will be scanned and electronically sent back to the applicant.

To request a Cooperative Agreement and/or a facility enrollment application, please submit your request in an email to Lori.Byrd@idph.iowa.gov. The subject line should state “WW Enrollment” and the Corporation/Lead Facility name. The Corporation/Lead Facility Cooperative Agreement needs to be renewed every six years. For further questions and to see if your application is up to date, please contact Lori Byrd at Lori.Byrd@idph.iowa.gov or 515-281-7709.

  • WISEWOMAN Healthcare Provider Manual  PDF-updated manual coming soon
  • WW Cooperative Agreement - submit a request 
  • WW Application for Facilities and Healthcare Providers - submit a request 
  • W-9 Form PDF

Claims Processing and Reimbursement Information

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 515-237-3974.

Electronic claim submission is now available, and only 837p (professional claims) will be accepted electronically. The billing or credentialing department must communicate with its clearinghouse and request transmission to MBS payer identification HSMBS. Guidance on the electronic billing process is available here.

The payer ID information is:

TriZetto Provider Solutions
One Financial Plaza
501 N Broadway, 3rd Floor
St. Louis, MO 63102

Paper claims may be submitted to: 

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

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. As a reminder, no participant in the above programs 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.

Educational Opportunity for WISEWOMAN Providers

Guidelines and Recommendations

Guidelines and recommendations related to Heart Disease:

Guidelines and recommendations related to Pap tests: