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 470-3495?
A: Form 470-3495 is the Managed Care Wraparound Payment Request form used in Iowa.
Q: What is the purpose of Form 470-3495?
A: Form 470-3495 is used to request wraparound payments for managed care services in Iowa.
Q: Who uses Form 470-3495?
A: Form 470-3495 is used by healthcare providers in Iowa.
Q: What are wraparound payments?
A: Wraparound payments are additional payments made to healthcare providers to cover services not covered by managed care plans.
Q: When should Form 470-3495 be filled out?
A: Form 470-3495 should be filled out when requesting wraparound payments for managed care services in Iowa.
Form Details:
Download a printable version of Form 470-3495 by clicking the link below or browse more documents and templates provided by the Iowa Department of Human Services.