TX HHS Form 2605. Member SK-SAI MDCP Review Signature

The TX HHS Form 2605, Member SK-SAI MDCP Review Signature, is a crucial document for reviewing the assessment results of the STAR Kids Screening and Assessment Instrument (SK-SAI). This form helps solve the problem of ensuring that member information is accurately captured and reviewed by the managed care organization.

The form typically requires information from the member or applicant, including their name, Medicaid number or Social Security number, date of birth, and name of a legally authorized representative (LAR) along with their relationship to the member. The form also includes sections for reviewing the SK-SAI assessment results, requesting peer-to-peer conversations between the managed care organization and treating physicians' offices, and providing additional feedback from the applicant/member/LAR.

Key features of this form include the required information and conditions outlined above. By using this form, healthcare professionals can ensure that member data is accurately captured and reviewed, facilitating more effective care management and coordination. The form is typically used in situations where a member's assessment results indicate a pending denial status, requiring further review and discussion with treating physicians' offices.

• The form is used to review SK-SAI assessment results and request peer-to-peer conversations between managed care organizations and treating physicians' offices.
• The form requires information from the member or applicant, including their name, Medicaid number or Social Security number, date of birth, and name of a legally authorized representative (LAR).