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Get Ia 470-2917 2017
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How to fill out the IA 470-2917 online
Filling out the IA 470-2917 form online is essential for individuals and agencies seeking to provide services under the Medicaid Home and Community-Based Services (HCBS) Waiver. This guide provides step-by-step instructions to help you navigate the form effectively and accurately.
Follow the steps to complete the IA 470-2917 online.
- Click the ‘Get Form’ button to obtain the IA 470-2917 and open it in the editor.
- Begin by filling out Section I, General Section: Specify the reason for the application by checking the appropriate box. Indicate any Managed Care Organizations (MCO) with which you want your application submitted.
- If you are applying as an individual for Consumer-Directed Attendant Care (CDAC), proceed to complete Section II. Enter your Social Security Number and check the applicable waiver types.
- If applying as an agency, fill out Section III. Check the appropriate MCOs and enter the Tax ID number and Taxonomy code.
- Finally, review your application thoroughly. Make sure to save your changes, download, print, or share the completed form as necessary.
Start completing your IA 470-2917 online today to streamline your application process and avoid delays.
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To find your member number for Medicaid, check the documents you received when you enrolled. You can also log into your Medicaid account on the Iowa Medicaid website. If you have further questions, don’t hesitate to contact customer service for assistance with form IA 470-2917.
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