Bureau of Substance Abuse - Integrated Provider Network - Documents & Forms

Below are the documents and forms available for reference and use by IPN Contractors.

Claims

IPN Claim Progress Report (January 2019)

IPN Claim Process Instructions (July 2020)

IPN Claim Process Instructions (August 2021)

Data Reporting

I-SMART Prevention User Manual (June 2019)

I-SMART Prevention User Manual (August 2020)

I-SMART Support Documentation (Substance Use Disorders)

I-SMART Support Documentation (Problem Gambling)

Problem Gambling Treatment Data Entry Matrix (February 2021)

SUD Treatment Data Entry Matrix (February 2021)

General

IPN Contract Guidance for COVID-19 (July 2021)PDF

IPN Critical Incident FormPDF

IPN Exception RequestPDF

IPN Provider Manual(April 2022)PDF

IPN Provider Manual (April 22) Release #1: Appendix O Revision  (May 2022)

IPN RFPPDF

IPN RFP Amendment #1-4PDF

IPN Service Area MapPDF

IPN Sliding Fee Modification Notice (December 2020)PDF

IPN Transportation ReceiptPDF

Your Life Iowa Logos

Prevention

IDPH Prevention Guide (August 2019)

IPN Prevention Services Orientation Guide (January 2019)

IPN Prevention Services Orientation Guide (July 2019)

IPN Prevention Services Orientation Guide (July 2020)

Responsible Gaming Presentation (September 2019)

Treatment

IPN Exception RequestPDF

IPN Transportation ReceiptPDF

IBHRS State Waitlist Guide (January 2022)PDF

IDPH State Waitlist Cover Sheet

State Waitlist Consent TemplatePDF

Recovery Peer Coaching Fact Sheet PDF

Your Life Iowa Referral and Follow-up Process (March 2021)

Please direct questions and technical assistance requests to the IPN Help Desk atipn@idph.iowa.gov.