WebForm 470-0254, Iowa MedicaidUniversal Provider Enrollment Application – Attach a photo copy of all certifications, licenses, or accreditation documents (See page 9 for a complete list of required supporting documentation.) Form 470-2965, Iowa Medicaid Provider AgreementGeneral Terms – Last page must be completed WebIowa Department of Human Services Certificate of Medical Necessity for Health and Disability Waiver Cap Increase Use this form as your cover page. Submit to Medical Services Waiver Prior Authorization via the Iowa Medicaid Portal Access (IMPA) System. (Please print or type clearly – accuracy is important) Section A

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WebFor a medical emergency, always call 911. Humana National Medicare (MCR): 1-866-588-5122. UnitedHealthcare Medicare National: 1-866-418-9812. UnitedHealthcare Group Retiree. 1-833-219-1182. HCSC Group Retiree. Group Retiree National Line Reservation/Ride Assist. http://secureapp.dhs.state.ia.us/impa/ greenheck explosion proof inline fans

Iowa Department of Human Services

WebControl Discloser (OCD) into the Iowa Medicaid Portal Access (IMPA) - Enter the number of OCD PINs needed. Signature and Date – Required Attach photo copy of Drivers License or State issued ID of the designated contact person-Required Mail Completed form to: Provider Correspondence/Provider Enrollment PO Box 36450 Des Moines, Iowa 50315 WebMake an account to access your Iowa Medicaid Login portal and administer your healthcare information with Iowa Total Care. Creating an account is free and easy. Learn more. WebManage your health from your phone with the Amerigroup mobile app! Call a nurse anytime, day or night, at the press of a button to answer your health questions. View your ID card to make check-in easier at your doctor visit or to fill prescriptions. Search for a nearby doctor or hospital. It’s all at the tip of your fingers! flutter string to bool