Form 470-5526 Authorized Representative for Managed Care Appeals - Iowa

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Form 470-5526 Authorized Representative for Managed Care Appeals - Iowa

What Is Form 470-5526?

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 470-5526?
A: Form 470-5526 is the Authorized Representative for Managed Care Appeals form in Iowa.

Q: What is the purpose of Form 470-5526?
A: The purpose of Form 470-5526 is to designate an authorized representative to act on behalf of an individual during the appeals process for managed care.

Q: Who can use Form 470-5526?
A: The form can be used by individuals in Iowa who are enrolled in Medicaid managed care and want to designate someone to represent them in the appeals process.

Q: Is there a deadline for submitting Form 470-5526?
A: There is no specific deadline for submitting Form 470-5526, but it is recommended to submit the form as soon as possible to ensure timely representation during the appeals process.

Q: Can I change my authorized representative after submitting Form 470-5526?
A: Yes, you can change your authorized representative at any time by submitting a new Form 470-5526 to your managed care organization.

Q: What should I do if I have questions about completing Form 470-5526?
A: If you have questions about completing Form 470-5526, you can contact your managed care organization or the Iowa Medicaid Enterprise for assistance.

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Form Details:

  • Released on April 1, 2021;
  • The latest edition provided by the Iowa Department of Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 470-5526 by clicking the link below or browse more documents and templates provided by the Iowa Department of Human Services.

Download Form 470-5526 Authorized Representative for Managed Care Appeals - Iowa

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