Form 470-4991 Iowa Medicaid Meals and Lodging Claim Form - Iowa

What Is Form 470-4991?

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 470-4991?
A: Form 470-4991 is the Iowa Medicaid Meals and Lodging Claim Form.

Q: What is the purpose of Form 470-4991?
A: The purpose of Form 470-4991 is to claim reimbursement for meals and lodging provided to Medicaid recipients in Iowa.

Q: Who can use Form 470-4991?
A: Form 470-4991 can be used by healthcare providers and facilities that have provided meals and lodging to Medicaid recipients.

Q: How do I submit Form 470-4991?
A: Form 470-4991 should be completed and submitted to the appropriate Iowa Medicaid office.

Q: What information is required on Form 470-4991?
A: Form 470-4991 requires information about the provider, recipient, dates of service, and details of the meals and lodging provided.

Q: Is there a deadline for submitting Form 470-4991?
A: Yes, Form 470-4991 should be submitted within 12 months from the date of service.