TX HHS Form 3691-A. Service Area Designation HCS. TxHmL. CDS and TAS

The TX HHS Form 3691-A, Service Area Designation HCS, TxHmL, CDS and TAS, is a crucial document that helps healthcare providers designate their service areas by region. This form is used to categorize the geographic areas where medical services are provided, ensuring accurate reporting and compliance with relevant regulations.

The form consists of two main sections: Section 1, which requires legal entity information, and Section 2, which allows users to specify their service areas by region. Depending on the contract type in Section 4, certain sections may be skipped or completed differently. For instance, if the contract type is CDS-CLASS, users should skip Section 2 and complete Section 3 instead.

This form is essential for healthcare providers to accurately report their services and comply with regulatory requirements. It is particularly useful when submitting reports to Texas Health and Human Services (HHS) or other relevant authorities. By designating service areas by region, healthcare providers can ensure that their services are properly categorized and reported, facilitating efficient data management and compliance.