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  • Ia 470-2486 2008

Get Ia 470-2486 2008-2025

PROVIDER SIGNATURE 470-2486 Rev. 7/08 FOR CONSUMER-DIRECTED ATTENDANT CARE CLAIMS ONLY DATE MEMBER/GUARDIAN SIGNATURE White Iowa Medicaid Enterprise Yellow Provider MEDICAID PAYMENTS PROVIDER CERTIFICATION I hereby agree To keep such records as are necessary to disclose fully the extent of services provided to individuals under the Iowa Medicaid Program as specified in the Provider Manual and the Iowa Administrative Code. Iowa Department of Human Services CLAIM FOR TARGETED MEDICAL CARE If handwritten use blue or black ink only. Accuracy is important. This form may be downloaded at http //www. ime. state. ia*us/Providers/index. html MEMBER INFORMATION STATE ID MEMBER S NAME LAST FIRST MI PROVIDER INFORMATION NPI PROVIDER NUMBER PROVIDER ADDRESS NAME STREET CITY STATE ZIP CODE OTHER INSURANCE IF NO LEAVE BLANK TAXONOMY CODE YES SERVICES A. B. C. D. PROCEDURE CODE PLACE OF FIRST DATE LAST DATE MM/DD/YY E* F* UNITS TOTAL LINE CHARGE TOTAL CLAIM CHARGES CLIENT PARTICIPATION AMOUNT THIRD PA....

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How to fill out the IA 470-2486 online

Filling out the IA 470-2486 form is an essential step for individuals seeking targeted medical care reimbursement through the Iowa Department of Human Services. This guide provides clear and supportive instructions to help users complete the form accurately and efficiently online.

Follow the steps to accurately complete the IA 470-2486 form online.

  1. Click the ‘Get Form’ button to access the online version of the IA 470-2486 form.
  2. Begin by entering the member information. Input the state ID and the member’s name in the respective fields. Make sure to provide the last name first, followed by the first name and middle initial.
  3. Proceed to the provider information section. Fill in the NPI provider number and provide the complete provider address, including street, city, state, and zip code.
  4. Indicate if the member has other insurance coverage by selecting ‘Yes’ or ‘No.’ If there is no other insurance, leave the space blank.
  5. If other insurance coverage is indicated, provide details regarding other insurance denial if applicable.
  6. List the services provided by filling in the procedure codes, place of service, first date, last date, units, and total line charge for each service rendered in the designated fields.
  7. Enter the total claim charges and the client participation amount if applicable.
  8. Provide details of any third-party payments if there are any; otherwise, leave the space blank.
  9. Sign the form in the authorized signature section, certifying that all statements are true and accurate.
  10. Finally, save your changes, and you can choose to download, print, or share the completed form as needed.

Complete your IA 470-2486 form online today for a hassle-free submission.

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Contact support

The mailing address for submitting Medicaid claims in Iowa is provided by the Iowa Medicaid Program. You can find this information on their official website, or by contacting IA 470-2486 for immediate assistance. Having the correct address is crucial for ensuring your claims are delivered accurately and on time. If you need help navigating the claims process, uslegalforms can assist you in filling out necessary forms and gathering required documentation.

You can contact the Iowa Medicaid provider by dialing IA 470-2486. This line provides direct access to the support team that can help with any questions or concerns regarding your Medicaid services. For added convenience, you can also visit the official Iowa Medicaid website for more resources and assistance. They strive to ensure you have a smooth experience.

To reach the Iowa Medicaid provider, you can call IA 470-2486. This number connects you to the customer service team who can assist you with inquiries and direct you to the appropriate resources. It is always a good idea to have your information ready when you call. They are there to help simplify your experience with Iowa Medicaid.

To verify Medicaid provider eligibility in Iowa, you can utilize the Iowa Medicaid Provider Portal. Simply log in and navigate to the eligibility verification section. Alternatively, if you prefer to speak to someone directly, calling the IA 470-2486 helpline will connect you with representatives who can assist you effectively.

If you want to email the Medicaid provider services in Iowa, use the address IMProviderServices@dhs.state.ia. Include relevant details in your email, such as your provider ID and any specific questions or concerns. For questions about forms or documentation like IA 470-2486, this is an appropriate channel for assistance.

To obtain your Iowa Medicaid number, you need to enroll in the Iowa Medicaid program. After you have successfully enrolled, your Medicaid number will be mailed to you, or you can view it online through your Medicaid account. If you have any issues, contact the IA 470-2486 help desk for support in retrieving or verifying your number.

In Iowa, Medicaid is referred to as Iowa Medicaid. This program provides critical health coverage to eligible residents, including low-income individuals and families. The Iowa Department of Human Services manages the program to ensure access to necessary health services. If you have questions about specific features, such as the IA 470-2486 form, visit the official Iowa Medicaid website.

To change your provider on Medicaid Iowa, first, visit the Iowa Medicaid portal. You will need to log in to your account and select the option to change your provider. Follow the prompts to select a new provider, ensuring that they are in your plan's network. If you need assistance, consider reaching out to the IA 470-2486 support team for detailed guidance.

The timely filing limit can vary widely based on the insurer and the specific healthcare services provided. Generally, limits can range from 90 days to one year. Reference the IA 470-2486 to help track your claims submissions, ensuring you meet required deadlines. Staying informed about these limits is essential for maintaining smooth transactions and securing rightful reimbursements.

Yes, Iowa Medicaid does accept paper claims, but electronic submissions are often preferred for faster processing. Submitting electronically with the IA 470-2486 can streamline the claims process and reduce the chance of errors. Always confirm the current guidelines regarding claim submission to ensure that you are compliant with their requirements. Keeping updated will help you avoid delays in receiving benefits.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232