TX HHS Form 2327-A. Room and Board Amendment to the Individual or Member and Provider Agreement

The TX HHS Form 2327-A, Room and Board Amendment to the Individual or Member and Provider Agreement, is a crucial document that helps individuals or members modify their monthly room and board payments. This form is typically used in situations where there is a change in the individual's or member's financial circumstances, requiring an adjustment to their monetary agreement.

This amendment form requires specific information, including the individual's or member's name, social security number, and provider details. The form also outlines the reasons for the change, such as a change in income or expenses. Additionally, it specifies the new monthly amount of room and board, effective date, and any responsibilities assumed by the individual or member.

The TX HHS Form 2327-A is an essential tool for ensuring that individuals or members and their providers are aware of any changes to their monetary agreement. By completing this form, parties can confirm their understanding of the new arrangements and avoid potential disputes. Key points to note include:

• Changes in monthly room and board payments
• Reasons for the change (e.g., income or expense adjustments)
• New effective date for the changed agreement
• Responsibilities assumed by the individual or member