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 used to review and validate information captured in the STAR Kids Screening and Assessment Instrument (SK-SAI). This form helps solve the problem of ensuring accurate and complete data for Medicaid recipients, particularly those with complex needs.

This form requires essential information such as the member's name, Medicaid number or Social Security number, date of birth, and details about their legally authorized representative. The form also includes sections for reviewing assessment results, requesting peer-to-peer conversations between managed care organizations and treating physicians' offices, and providing additional feedback from applicants/members/LARs.

This form should be used when a member's SK-SAI assessment results in a pending denial status or requires further review. It is an important tool for ensuring that Medicaid recipients receive the necessary services and support to meet their unique needs. By completing this form, members can provide critical information and feedback to facilitate a more informed decision-making process.