This version of the form is not currently in use and is provided for reference only. Download this version of Form 470-5526 for the current year.
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 470-5526?
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.
Form Details:
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.