TX HHS Form H3618-A. Resident Transaction Notice for Designated Vendor Numbers

The TX HHS Form H3618-A, Resident Transaction Notice for Designated Vendor Numbers, is a document used to record transactions related to Medicaid recipients' transfers of assets. This form helps solve the problem of tracking these transactions, ensuring compliance with regulations and maintaining accurate records.

This form requires specific information, including the recipient's Medicaid number, social security number, Medicare or Railroad Retirement claim number, name, and designated vendor numbers for facilities such as Mason Manor and Home Equity Manor. The form also includes sections for noting the location of the resident within a facility and recording transaction dates. Common scenarios of use include transfers between different care facilities or changes in residency status.

The TX HHS Form H3618-A should be used whenever a Medicaid recipient's assets are being transferred, such as when moving from one long-term care facility to another. The form must be completed on the same date for both discharge and admission transactions, with the designated vendor number and current vendor number clearly indicated. This form is an essential tool for maintaining accurate records and ensuring compliance with regulations.