IA 470-2917 2017 free printable template
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Iowa Department of Human Services Iowa Medicaid HUBS Waiver Provider Application Basic Information To avoid delays in the enrollment process, you should: Complete all required forms listed below.
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People Also Ask about
How do I report changes to Medicaid in Iowa?
For problems or concerns regarding your local DHS office contact the Central Office at 1-800-972-2017 or by email at contactdhs@dhs.state.ia.us.
What is the authorized representative form for Medicaid in Iowa?
Clients may use Form 470-3948 when there is a need to designate a personal representative. A "personal representative" is someone designated by another as standing in the other's place or representing the other's interest for one or more purposes. Record of Disclosure of Health Information, Form 470-4015.
What are the Medicaid guidelines for 2023 in Iowa?
In 2023, the Medically Needy Income Limit (MNIL) for individuals is the same as for married couples and is $483 / month. The amount one must “spend down” can be thought of as a deductible. It is the difference between one's monthly income and the MNIL. In IA, the spend down is calculated for a 2-month period.
What is the form for Medicaid reconsideration in Iowa?
Form 470-5526 shall be completed by the Medicaid member or their parent, if the member is a minor. The member and the authorized representative must both sign the form. Once completed, the form should be submitted to the Medicaid member's MCO, if for a managed care appeal, or to HHS, if for a state fair hearing.
How do I become a Medicaid provider in Iowa?
Providers wanting to enroll as an Iowa Medicaid provider must submit an enrollment application to the Iowa Medicaid Enterprise (IME) Provider Enrollment Unit. No payment will be made to a provider for services prior to the effective date of the department's approval of an application.
How do I appeal Medicaid denial in Iowa?
You also may call the Appeals Section at (515) 281-3094 or send us an email at appeals@dhs.state.ia.us if you have questions. We accept collect phone calls.
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What is IA 470-2917?
IA 470-2917 is a form used by the State of Iowa to report specific information related to state tax obligations.
Who is required to file IA 470-2917?
Individuals and businesses that have certain income types or transactions that require reporting under Iowa tax law are required to file IA 470-2917.
How to fill out IA 470-2917?
To fill out IA 470-2917, you need to provide your personal information, report your income or transaction details, and follow the instructions provided on the form.
What is the purpose of IA 470-2917?
The purpose of IA 470-2917 is to collect necessary information for tax compliance and to ensure that individuals and businesses meet their state tax obligations.
What information must be reported on IA 470-2917?
The form requires reporting personal identification details, types of income, transaction amounts, and any applicable deductions or credits.
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