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Department of Human Services of Iowa fax number
(515) 725-1351
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Iowa Medicaid Enterprise – Member Services (Iowa Department of Health and Human Services)
Used for: Billing inquiries, Medically Exempt requests (Medically Exempt Member Survey and Medically Exempt Attestation and Referral Form), and other Iowa Medicaid Member Services communications
Fax destination details
- Department
- Iowa Medicaid Enterprise – Member Services (Iowa Department of Health and Human Services)
- Purpose
- Billing inquiries, Medically Exempt requests (Medically Exempt Member Survey and Medically Exempt Attestation and Referral Form), and other Iowa Medicaid Member Services communications
- Form
- Medically Exempt Attestation and Referral Form — Medically Exempt Attestation and Referral Form
- Address
- Iowa Medicaid Member Services, Lucas Building, 321 East 12th Street, Des Moines, IA 50319
- Voice phone
- 1-800-338-8366
- Website
- Visit organization website
Before you send
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Submit the Medically Exempt Attestation and Referral Form by mail or fax to IME Member Services (Attn: Medically Exempt). Mail: Iowa Medicaid Enterprise Member Services (Attn: Medically Exempt), PO Box 36510, Des Moines, IA 50315; Fax: 515-725-1351; Email: IMEmemberservices@dhs.state.ia.us
Official form instructions are published as a downloadable file on the organization's website.
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