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N*: Hourly wage*: Employer s first and last name*: Pay period from: Date* Start Time* 470-4429 (Rev. 4/08) End Time* Start Time* End Time* Total Hours Worked* Rate of Pay* 1 SERVICE PROVIDED AND NARRATIVE* Services provided must match service on the individual budget. Please identify in the narrative if hours worked are from the emergency back up plan or from savings. (Use more than one line if needed.) Note any progress/changes for consumer. Iowa Department of Human Services *.

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How to use or fill out the Consumer Choice Options online

Filling out the Consumer Choice Options online can seem daunting, but with a clear understanding of each component, the process becomes straightforward. This guide will walk you through the necessary steps to complete the time sheet efficiently and accurately.

Follow the steps to successfully complete the Consumer Choice Options form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the employer or Medicaid number in the specified field. This number is crucial for identifying the funding source for the services provided.
  3. Fill out the employee's name in the designated section. Ensure that you provide the complete name as it appears in official documents.
  4. Input the social security number for the employee. This is a necessary field to verify the individual's identity.
  5. Next, enter the position of the employee. Clearly indicate the role they are performing to prevent any confusion later.
  6. Provide the hourly wage of the employee in the corresponding section. This amount should reflect their agreed pay rate.
  7. Input the employer’s first and last name in the designated space. This information is essential for accountability.
  8. Indicate the pay period by entering the start and end dates. Accurate dates are necessary for processing payment.
  9. Document the start and end times for each service provided. Make sure to enter these times accurately to the nearest quarter hour.
  10. In the total hours worked section, calculate the total hours the employee has worked during the pay period. This should match the documented start and end times.
  11. Provide a narrative of the services rendered. Specify if the hours are from the emergency back-up plan or savings and note any progress or changes regarding the consumer.
  12. Both the employee and employer must sign the form in the designated areas, along with the dates of signing. This step ensures all parties recognize and agree to the information provided.
  13. Finally, review the completed form for accuracy. Once confirmed, you may save changes, download, print, or share the form as necessary.

Start filling out your documents online today to ensure timely processing and payment.

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Related links form

Canada IMM 1295 E 2018 GCAAR 1301 2016 PA SP 4-127 2012 CA SOC 341 2006

Questions & Answers

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Contact support

For more information on the Consumer Choices Option (CCO) program, please visit the Veridian CCO website at https://.veridianfiscalsolutions.org/cco or email us at ccoiowa@veridiancu.org. You can also call us at (866) CCO-IOWA or (319) CCO-IOWA.

The Consumer Choices Option (CCO) is an option that is available under the Home- and Community-Based Services (HCBS) waivers that gives you control over a targeted amount of Medicaid dollars so that you can develop a plan to meet your needs by directly hiring employees and/or purchasing other goods and services.

Most Iowa Medicaid members are enrolled in the IA Health Link managed care program. MKSN members receive coverage from the IA Health Link program. This program gives you health coverage through a Managed Care Organization (MCO) that you get to choose.

Members that are eligible for both Medicare and Iowa Medicaid are required to be enrolled with a Medicare Part D plan. Your Medicare Part D plan is now responsible for your prescription drugs.

Members should call Iowa Medicaid Member Services for help at 1-800-338-8366 or locally in the Des Moines area at 515-256-4606.

Medicaid is a state-federal funded program that is administered by the Department of Human Services of the State of Iowa.

the range of competing products and services from which a consumer can choose.

Consumer Choices Option (CCO) is an Iowa Medicaid program for Iowans with disabilities and aging Iowans. CCO allows individuals on Home and Community Based Services (HCBS) waivers more flexibility over how their services are provided.

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