Form 470-5210 Dental Wellness Plan Wraparound Payment Request - Iowa

What Is Form 470-5210?

This is a legal form that was released by the Iowa Department of Human Services - a government authority operating within Iowa. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 470-5210?
A: Form 470-5210 is a Dental Wellness Plan Wraparound Payment Request form specifically used in Iowa.

Q: What is a Dental Wellness Plan?
A: A Dental Wellness Plan is a type of dental insurance or program that provides coverage for various dental services.

Q: What is a Wraparound Payment Request?
A: A Wraparound Payment Request is a form used to request additional payment for dental services that are not covered by the primary dental insurance.

Q: Who can use Form 470-5210?
A: Form 470-5210 can be used by dental providers in Iowa who are participating in the Dental Wellness Plan.

Q: What information is required on Form 470-5210?
A: Form 470-5210 requires information such as the provider's name, address, and National Provider Identifier (NPI), as well as the patient's information and details about the dental services provided.

Q: Are there any specific instructions for completing Form 470-5210?
A: Yes, specific instructions for completing Form 470-5210 are usually provided on the form itself or in a separate guideline document.

Q: What is the purpose of the Dental Wellness Plan Wraparound Payment Request?
A: The purpose of the Dental Wellness Plan Wraparound Payment Request is to request additional payment for dental services that are not covered by the primary dental insurance.

Q: Is Form 470-5210 specific to Iowa?
A: Yes, Form 470-5210 is specific to Iowa and is used in relation to the Dental Wellness Plan offered in the state.

Q: Can individuals use Form 470-5210 to request reimbursement for dental services?
A: No, Form 470-5210 is specifically for dental providers to request additional payment for services, not for individuals to request reimbursement.