TX HHS Form 4123. Nurse Services Delivery Log - Billable Activities

The TX HHS Form 4123, Nurse Services Delivery Log - Billable Activities, is a crucial tool for healthcare professionals to track and document various nursing services delivered to patients. This form helps solve the problem of accurately recording and reporting billable activities, ensuring compliance with regulatory requirements.

This log requires information on various tasks performed by nurses, including preparing and administering medication, assessing health status, reviewing documents, and communicating with pharmacists or insurance providers. Key sections include face-to-face or video conference assessments (CO), treatment administration (CT), and RN-only activities such as delegating nursing tasks and supervising LVNs. The form also includes space for documenting special needs training and participating in service planning meetings.

The TX HHS Form 4123 is intended for use by nurses delivering home and community-based services, including Texas Home Living Services NAY D022 services. This log should be used to document billable activities as ordered, with additional supporting documentation required for activities denoted by an asterisk (e.g., reports, assessments). By using this form, healthcare professionals can ensure accurate and timely reporting of nursing services, facilitating reimbursement and quality care evaluation.