Get Rev - Lien Recovery Procedure - Dhs Iowa

The REV - Lien Recovery Procedure is essential for ensuring the Iowa Department of Human Services can recover payments made on behalf of Medicaid members. This guide will provide clear, step-by-step instructions on how to fill out this form online, assisting users in navigating the process with ease and confidence.

Follow the steps to complete the REV - Lien Recovery Procedure effectively.

1. Press the ‘Get Form’ button to access the REV - Lien Recovery Procedure form online.
2. Carefully read the form instructions provided alongside the document to ensure accurate completion.
3. Begin filling out the user information section, providing necessary details such as the Medicaid member's name, address, and Medicaid ID.
4. In the next section, input the details of the third-party liability, including the name of the liable party and the case number, if applicable.
5. Complete the section for the date of the incident, ensuring it aligns with relevant documentation and records.
6. Document the current amount of the lien owed by the liable third party as calculated based on related medical claims.
7. Review all filled information for accuracy, making sure that all required fields are completed to avoid any delays.
8. Once all sections are filled out and verified, proceed to save your changes and download the form for your records.
9. If needed, you can print the document directly from the online platform for submission.
10. Finally, submit the completed REV - Lien Recovery Procedure form as directed in the instructions, ensuring all attached documents are included.

Complete your REV - Lien Recovery Procedure form online now to ensure a smooth recovery process.