TX HHS Form 1290. Long Term Care Claim

The TX HHS Form 1290, Long Term Care Claim, is a crucial document for healthcare providers to claim reimbursement for services rendered to patients in long-term care facilities. This form helps solve the problem of ensuring that healthcare providers receive fair compensation for their services, thereby promoting continuity of care and patient well-being.

The form consists of three main sections: Header Information, Nurse Aide Training, and Line Item Information. The first section requires basic information about the claimant, while the second section collects details about the nurse aide training provided. The third section is where healthcare providers report the services they have rendered, including the number of units and any negative numbers that need to be displayed as decimal fractions.

Before submitting the form, claimants must certify that the information provided is true, accurate, and complete to the best of their knowledge. They also understand that claiming for services not actually provided constitutes fraud. The form requires a signature and date from the claimant. Key features of this form include the requirement for negative numbers to be displayed as decimal fractions in the Line Item Information section.

• This form is used by healthcare providers to claim reimbursement for long-term care services.
• The form consists of three main sections: Header Information, Nurse Aide Training, and Line Item Information.
• Claimants must certify that the information provided is true, accurate, and complete to the best of their knowledge.