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Iowa Retrospective Payment Rule

Effective July 1, 2010, an Iowa Insurance Division rule that requires retrospective in-network payment to physicians will expand to include advanced nurse practitioners and physician assistants. 

Key provisions of the rule are:

• providers delay submitting claims until their credentialing applications have been approved
• services rendered during the credentialing period are considered in-network

Midlands Choice provider file updates, including retroactive effective dates of providers impacted by this rule, are completed after the credentialing committee meets on the second Wednesday of each month.