Iowa Network Management Systems Agreement

State:
Multi-State
Control #:
US-CP1026-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Network Management Systems Agreement document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

All providers who have submitted an application to join Iowa Total Care have the right to be informed of the status of their application upon request. To obtain status, contact Provider Services at 1-833-404-1061 (TTY 711).

Benefits and Services Call us at 1-833-404-1061 (TTY: 711).

Iowa Total Care's Medicaid plans offers comprehensive health care benefits and services that suit the needs of families and individuals throughout Iowa. View some of Iowa Medicaid member services and benefits from Iowa Total Care below.

All providers who have submitted an application to join Iowa Total Care have the right to be informed of the status of their application upon request. To obtain status, contact Provider Services at 1-833-404-1061 (TTY 711).

Iowa Total Care is one of the MCOs providing services.

Visit the Iowa Medicaid Enterprises (IME) Provider Services website or call 1-800-338-7909 (option 2) or 515-256-4609 (option 2) to request the forms to apply to be an ICDAC provider.

Call our automated Member eligibility IVR system. Call our toll-free Provider Services number at 833-404-1061 from any touch-tone phone and follow the appropriate menu options to reach our automated member eligibility-verification system 24 hours a day.

Required Documents for Enrolling as an Iowa Medicaid Provider: Iowa Medicaid Universal Provider Enrollment Application (470-0254) Electronic Funds Transfer (EFT) Authorization Form. Provider Agreement. W-9 IRS Form. Designated Contact Person.

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Iowa Network Management Systems Agreement