Form 470-3495 Managed Care Wraparound Payment Request - Iowa

Form 470-3495 Managed Care Wraparound Payment Request - Iowa

What Is Form 470-3495?

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 470-3495?
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.

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Form Details:

  • Released on May 1, 2017;
  • 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 470-3495 by clicking the link below or browse more documents and templates provided by the Iowa Department of Human Services.

Download Form 470-3495 Managed Care Wraparound Payment Request - Iowa

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