TX HHS Form 7484. Hospital Report for Newborn Child or Children

The TX HHS Form 7484, Hospital Report for Newborn Child or Children, is a crucial document that helps hospitals report the birth of a child to the Texas Health and Human Services Commission (HHSC). This form is used by hospitals to provide essential information about newborn children whose mothers are currently eligible under the Texas Medicaid Program. The hospital must complete this form within five days after the birth of the child to avoid delays in receiving notice of the Medicaid Recipient number.

The form requires hospitals to provide specific information, including the mother's name and date of birth, the child's name, sex, and date of birth, as well as the hospital's name and address. Additionally, the form asks if the mother has relinquished her rights to the newborn child, and if so, provides a space for the date of relinquishment.

To ensure timely processing of Medicaid claims, hospitals must retain all newborn claims until they receive a client number for the child. Once assigned, the hospital should submit all newborn claims to TMHP using the newly assigned client number. The form also emphasizes the importance of completing and submitting it within five days after the birth of the child to avoid delays in receiving notice of the Medicaid Recipient number.

• The form is used by hospitals to report the birth of a child whose mother is currently eligible under the Texas Medicaid Program.
• The hospital must complete and submit the form within five days after the birth of the child to avoid delays in receiving notice of the Medicaid Recipient number.
• The form requires specific information about the mother, child, and hospital.