Form 470-3748 Iowa Medicaid Enterprise Ambulance Verification of Compliance - Iowa

What Is Form 470-3748?

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 470-3748?
A: Form 470-3748 is a verification of compliance form for the Iowa Medicaid Enterprise Ambulance program in Iowa.

Q: Who needs to submit Form 470-3748?
A: Ambulance providers participating in the Iowa Medicaid Enterprise program need to submit Form 470-3748.

Q: What is the purpose of Form 470-3748?
A: The purpose of Form 470-3748 is to verify compliance of ambulance services with Iowa Medicaid Enterprise program requirements.

Q: What information is required on Form 470-3748?
A: Form 470-3748 requires information about the ambulance provider, compliance with state and federal regulations, and verification of Medicaid and Medicare enrollment.

Q: Are there any submission deadlines for Form 470-3748?
A: Yes, Form 470-3748 needs to be submitted annually. The specific deadline will be communicated by the Iowa Medicaid Enterprise Ambulance program.

Q: What happens if I don't submit Form 470-3748?
A: Failure to submit Form 470-3748 may result in the termination or suspension of participation in the Iowa Medicaid Enterprise Ambulance program.

Q: Is there a fee for submitting Form 470-3748?
A: There is no fee for submitting Form 470-3748.

Q: Can I submit supporting documentation with Form 470-3748?
A: Yes, you can submit supporting documentation with Form 470-3748 to provide additional evidence of compliance with program requirements.