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Patient Financial Services 3281 Ridgeway Dr. Suite 300 Colville, IA 52241 866.393.4605 Tel 319.356.2862 Fax www.uihc.org/billpayWe are happy you have chosen University of Iowa Hospitals and Clinics
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To fill out health care support services, follow these steps:
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Begin by gathering all the necessary information such as personal details, medical history, and any existing health care plans or coverage.
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Look for the relevant health care support services form or application provided by the respective organization or agency.
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Start by providing your personal details like name, contact information, and address.
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Proceed to fill out the sections related to your medical history, including any pre-existing conditions, allergies, or medications you are currently taking.
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Submit the completed form, either online or through mail, to the appropriate organization or agency that offers health care support services.
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Who needs health care support services?

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Health care support services are needed by individuals who require assistance and support in managing their healthcare needs.
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- Elderly individuals who may have physical limitations or chronic health conditions requiring regular monitoring and support.
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- Individuals with mental health conditions who may benefit from counseling, therapy, or medication management services.
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- Individuals with limited or no health insurance coverage who need help accessing affordable healthcare options and resources.
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The specific eligibility criteria for health care support services may vary depending on the organization or agency providing the services.
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Health care support services are services provided to individuals to assist in their health care needs, such as home health aides, personal care attendants, and medical transportation services.
Health care providers or organizations responsible for providing health care support services are required to file.
Health care support services can be filled out by providing detailed information about the services provided, including dates of service, type of service, and billing information.
The purpose of health care support services is to ensure individuals receive the necessary care and support to maintain their health and well-being.
Information that must be reported on health care support services includes details about the services provided, the individuals receiving the services, and any billing or payment information.
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