Iowa Family Investment Program

State of Iowa

Official Website: https://dhs.iowa.gov/cash-assistance

Forms & Documents

Browse all Iowa Family Investment Program government forms

21 - 40 of 65 forms

Form Title Topics
Family Planning Program Provider Attestation
Health Insurance Premium Payment (HIPP) Provider Invoice
Home- and Community-Based Services (HCBS) Intellectual Disability Waiver Priority Need Assessment – Statewide Waiting List
Home- and Community-Based Services (HCBS) Nonresidential Setting Assessment
Home- and Community-Based Services (HCBS) Residential Setting Member Assessment
Inpatient Medicaid Prior Authorization
Insurance Update Fee-for-Service (FFS) Members
Integrated Health Homes (IHH) Managed Care Organizations (MCOs) Notification
Intermediate Care Facilities for Individuals with an Intellectual Disability Calculation Worksheet
Iowa Medicaid Accountable Care Organization (ACO) Agreement
Iowa Medicaid Addendum to Dental Provider Agreement for Orthodontia
Iowa Medicaid Enterprise (IME) Inpatient Psychiatric Prior Authorization
Iowa Medicaid Enterprise (IME) Provider Enrollment Application Fee Hardship Exemption Request
Iowa Medicaid Health Home Provider Agreement
Iowa Medicaid Health Home Provider Application
Iowa Medicaid Integrated Health Home Provider Agreement General Terms
Iowa Medicaid Managed Care Wraparound Payment Request Form
Iowa Medicaid Meals and Lodging Claim
Iowa Medicaid Memorandum of Understanding (MOU) for Value Based Purchasing Support Activities
Iowa Medicaid Mileage Reimbursement Trip Log and Claim Form

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