TX HHS Form 1595. Billing Resolutions Request

The Texas Health and Human Services (HHS) Form 1595, Billing Resolutions Request, is a crucial document used to request billing resolutions for services provided by contractors. This form serves as a tool for contractors to communicate with the HHS agency regarding any discrepancies or issues related to payment processing.

Aimed at contractor representatives and CMS coordinators, this form requires specific information, including contact details, service group codes, and error code numbers. The document also includes spaces for signatures from both the contractor representative and the CMS coordinator, indicating their involvement in the billing resolution process. By filling out Form 1595, contractors can efficiently resolve billing issues and ensure timely payment for services rendered.

This form is an essential tool for HHS to manage its relationships with contractors and ensure compliance with billing regulations. As such, it is crucial that all supporting documentation, including forms 2101, 2065, 2067, R&S reports, or Claim Detail Reports, be attached to the completed Form 1595. By using this form, both HHS and contractors can work together to resolve billing disputes in a timely and efficient manner.