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.
Q: What is form 470-5479?
A: Form 470-5479 is a Wraparound Payment Request Access form for the Iowa Medicaid Portal Access (IMPA) System.
Q: What is a Wraparound Payment Request?
A: A Wraparound Payment Request is a request foradditional payment for services offered to Medicaid recipients that are not covered by the Medicaid program.
Q: Who can access the IMPA System?
A: Individuals and organizations that provide Medicaid services in Iowa can access the IMPA System.
Q: Why would someone need to submit Form 470-5479?
A: Form 470-5479 needs to be submitted to request access to the Wraparound Payment Request feature in the IMPA System.
Q: Is there a fee for accessing the IMPA System?
A: No, there is no fee for accessing the IMPA System.
Q: What information is required on Form 470-5479?
A: Form 470-5479 requires basic information about the individual or organization requesting access, as well as a certification statement and signature.
Q: How long does it take to process Form 470-5479?
A: The processing time for Form 470-5479 may vary, but it generally takes a few weeks for access to be granted.
Q: Who can I contact for more information about Form 470-5479?
A: For more information about Form 470-5479 and the IMPA System, you can contact the Iowa Medicaid program.
Form Details:
Download a fillable version of Form 470-5479 by clicking the link below or browse more documents and templates provided by the Iowa Department of Human Services.