Iowa Application Service Provider Agreement
Description
How to fill out Application Service Provider Agreement?
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FAQ
The waiting period for Medicaid approval in Iowa is an integral part of the application process. After submitting your application, the Department of Human Services (DHS) will typically take about 30 to 45 days to process your application, although the timeframe can vary.
Primary services funded through Medicaid are physician, hospital, and long-term care. Additional coverage includes prescription drugs, medical equipment, transportation, family planning, laboratory tests, and other medical services. These services are covered only if they are medically necessary.
The Medicaid program is funded by Federal and state government and is managed by the Iowa Department of Human Services.
Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. Iowa Total Care pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and many more. Call Member Services at 1-833-404-1061 (TTY: 711).
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.