Keyword Analysis & Research: cdac claim form 470 2486


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Frequently Asked Questions

Will EVV replace the CDAC daily service record (form 470-4389)?

Will EVV replace the CDAC Daily Service Record (Form 470-4389)? Service documentation in EVV systems that capture all the requirements of form 470-4389 will be accepted in lieu of paper form 470-4389.

Will my CDAC services auto populate?

For CDAC services, they will auto populate. Individual CDAC care plan activities will also be auto populated. CCO population will be completed by Veridian Fiscal Solutions (VFS). Where do I find our agency Provider ID?

Where can I get an original copy of a claim form?

Original versions of the CMS-1500, UB-04 and Dental Claim forms can be found at office supply stores. Originals of the Targeted Medical Care claim forms can be requested from IME by contacting Provider Services at 1-800-338-7909or locally at 515-256-4609. Health Insurance Claim Form Instructions and Sample Forms

What documentation can be used in lieu of form 470-4389?

Service documentation in EVV systems that capture all the requirements of form 470-4389 will be accepted in lieu of paper form 470-4389. If the client is a child and cares are passed to another nurse instead of a guardian/parent we can add that as a reason for no Client Attestation, correct?


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