441—120.2(237A) Application for payment. A provider shall apply for payment on Form 470-2890, Payment Application for Nonregistered Providers, provided by the department’s local office or on the department’s website. The provider shall also use Form 470-2890 to inform the department of any changes in circumstances that would affect the provider.
[ARC 2648C, IAB 8/3/16, effective 10/1/16]