TX HHS Form H1062. Birth Outcome Reminder Letter

Texas Health and Human Services (HHS) issues Form H1062, the Birth Outcome Reminder Letter, to individuals enrolled in the CHIP Perinatal program. This notice is not a traditional form with fields; instead, it is an instructional letter explaining what the recipient must do after the birth of a baby. The letter is time-sensitive because it affects whether the newborn can receive Medicaid coverage from birth and whether the family may be billed for labor and delivery costs.

Purpose of Form H1062

Form H1062 serves as an official reminder that the state must receive specific information about the newborn and a completed Form H3038-P – CHIP Perinatal Emergency Medical Services Certification. This process determines whether Emergency Medicaid will cover parts of the delivery costs and ensures proper enrollment of the newborn in Medicaid or CHIP coverage.

In other words, the letter tells the parent: “Your baby has been born or is expected soon — here is what you must do to protect your benefits.”

What the Notice Contains and What Each Section Means

1. Instructions to Report the Baby’s Information

The first section asks the recipient to report three basic facts about the newborn:

• Date of birth
• Gender (male or female)
• Baby’s name

This information is essential for creating the child’s Medicaid or CHIP case. A delay here is one of the most common reasons babies temporarily lose eligibility.

2. How to Submit the Information

The letter provides three submission methods:

• Calling 2-1-1 or 1-877-KIDS-NOW
• Faxing a letter to the toll-free number
• Mailing the information to the Texas HHS address in Austin

Recipients often overlook that a simple phone call is acceptable—many wait to mail documents, causing unnecessary delays.

3. Required Next Steps for Emergency Medicaid Processing

Because CHIP Perinatal covers only prenatal and limited delivery services, some costs must be billed through Emergency Medicaid. This part of the notice explains two mandatory steps:

• Take Form H3038-P to the doctor or hospital for completion after the baby is born.
• Send the completed form back to Texas HHS by mail or fax.

The H1062 letter reminds the recipient to bring the form with them to the hospital—many people forget, resulting in last-minute scrambling or delays in processing claims.

4. Consequences of Not Following the Instructions

The notice makes it very clear:

• The family may have to pay labor and delivery costs out of pocket.
• The newborn may not receive Medicaid coverage from birth through the first birthday.

These consequences are not warnings—they are actual outcomes regularly faced by families who fail to return Form H3038-P on time.

Common Mistakes Recipients Make

• Assuming the hospital will automatically send the certification — it will not.
• Forgetting to take Form H3038-P to the delivery hospital.
• Sending incomplete forms (missing provider signature or dates).
• Waiting too long to report the newborn’s information.
• Throwing the envelope away and then delaying the mailing of the form.

Legal and Program Requirements Behind the Notice

The notice is issued under Texas Health and Human Services Commission policy governing:

• CHIP Perinatal benefits (Title 1, Part 15 of the Texas Administrative Code)
• Emergency Medicaid eligibility requirements under federal law
• Medicaid newborn automatic enrollment rules

Form H1062 is mandatory because the state must verify delivery details before Emergency Medicaid pays hospital claims and before a newborn can be enrolled correctly.

Practical Tips for Responding to This Notice

• Call 2-1-1 as soon as the baby is born—this is the fastest method.
• Ask the doctor to complete Form H3038-P before you leave the hospital.
• Take a photo of the completed form for your personal records.
• Use the prepaid envelope immediately; do not wait several days.
• If faxing, keep the fax confirmation page.

Real-Life Examples of When This Notice Is Used

• Example 1: A mother receives perinatal services and delivers earlier than expected. The hospital does not send paperwork automatically, so she uses this reminder to submit the required certification.
• Example 2: A family moves before the due date and misses earlier mail from HHS. This letter ensures they know what is needed for the newborn’s Medicaid.
• Example 3: A parent assumes CHIP covers the entire delivery. After receiving H1062, they learn they must complete an Emergency Medicaid certification to avoid large hospital bills.
• Example 4: A doctor forgets to sign the H3038-P form. The family catches the mistake only because they reviewed the instructions in this letter.

Documents You May Need

• Completed Form H3038-P (signed by doctor or hospital)
• Baby’s birth certificate (if available; not always required immediately)
• Any hospital discharge documents
• Identification for communicating with 2-1-1
• Fax confirmation or mailing receipt

FAQ

• Is Form H1062 something I fill out? No. It is a reminder letter with instructions, not a form with fields.
• What happens if I do not submit Form H3038-P? Emergency Medicaid may not pay delivery costs, and your baby may lose Medicaid eligibility.
• Can I report my baby’s information by phone? Yes, calling 2-1-1 is the fastest and preferred method.
• Does the hospital send the form for me? Usually not. Parents must mail or fax it themselves.
• How fast must I respond? As soon as possible—processing delays may lead to coverage gaps.
• Do I need the birth certificate? Often not immediately, but it can help resolve case discrepancies.
• Can I fax instead of mailing? Yes, faxing is accepted and often faster.

Micro-FAQ (Short Answers)

• Purpose? To remind recipients to report a newborn and submit Form H3038-P.
• Who receives it? Individuals in the CHIP Perinatal program.
• Deadline? As soon as the baby is born.
• Required attachments? Completed Form H3038-P.
• Submitted to? Texas Health and Human Services.
• Delivered how? Phone, fax, or mail.
• Legal effect? Determines eligibility for Emergency Medicaid and newborn coverage.
• What if ignored? Possible hospital bills and loss of newborn Medicaid.

Related Forms

• Form H3038-P – CHIP Perinatal Emergency Medical Services Certification
• Texas Medicaid Newborn Enrollment Forms
• CHIP Perinatal Program Eligibility Notices

Form Details

• Form Name: Birth Outcome Reminder Letter
• Form Number: H1062
• Agency: Texas Health and Human Services Commission
• Region: Texas
• Edition Date: 08-2015