Iowa Dental Wellness Plan and Hawki Grievances and Appeals

What is an appeal?

An appeal is when you ask us to look at our decision again about your care or benefits.

How to ask for an appeal

• You have 60 days from the date on this letter to ask for an appeal.
• Who can ask: You, someone you choose to act for you (with your written permission), or your provider (with your written permission).
  • To give a family member or your provider permission to act for you, please complete this form.    
• How to ask: Call, mail, or fax us. You can also ask for a fast (expedited) appeal if waiting could seriously harm your health.
  
  Send your appeal to:
  DentaQuest Grievance and Appeals
  Attn: Appeals
  P.O. Box 8206
  Des Moines, IA 50301
  Call: 1-866-629-6074 (TTY 711)
  Fax: 1-262-387-3734

What to include:

• What service you asked for and why you are appealing.
• Any information you want us to review (for example, medical records or doctor letters).

Appeal timelines

• Standard appeal: We decide no later than 30 days after we get your appeal.
• Fast (expedited) appeal: If your health could be in harmed by waiting, we decide within 72 hours.
• More time (up to 14 extra days): We may take more time if we need more information and it is in your best interest. If we take more time, we will send you a letter.
• If you disagree with our decision to take more time, you may file grievance.
   

You may ask for a State Fair Hearing if you do not agree with our decision or if we do not decide your appeal on time. You must ask within 120 days from the date on the appeal decision letter.

• You can choose someone to speak to or make decisions for you, but you must put this in writing.
  • To give a family member or your provider permission to act for you, please complete this form.   
• Asking does not guarantee a hearing.
• You must finish your Appeal with us before asking for a State Fair Hearing.
• You can ask in any of these ways:

Online: https://hhs.iowa.gov/appeals
Mail:
Department of Health and Human Services
Appeals Bureau,
321 E 12th St, 4th Floor
Des Moines, IA 50319

Appeals Phone: 1-888-723-9637
Appeals Fax: 1-515-564-4044
Appeals email address: appeals@hhs.iowa.gov
Electronic form located at:  https://hhs.iowa.gov/appeals

Keeping Your Benefits During a State Fair Hearing

You may be able to keep getting your services while your appeal is being reviewed. This applies if we stopped or reduced a service you were already getting.

To keep your service, you must:

• Ask for a fair hearing, and

• Ask to keep your service
   

You must do this within 10 days of the date on your appeal letter, or before your current approval ends. If the final decision is not in your favor, you may have to pay for the services you received during this time.