TX HHS Form 5202. Patient Navigation Consent
The TX HHS Form 5202, Patient Navigation Consent, is a crucial document that helps solve the problem of ensuring patients receiving navigation services understand their ongoing care coordination needs.
TX HHS Form 4801. State Fair Hearing Evidence Packet Cover Page
The TX HHS Form 4801, State Fair Hearing Evidence Packet Cover Page, is a crucial document that helps resolve eligibility disputes for individuals enrolled in the Medically Dependent Children Program (MDCP) or STAR+PLUS Home and Community Based Services (HCBS) program.
TX HHS Form 4807-D. Action Taken on Hearing Decision
Form 4807-D is used by Texas Health and Human Services (HHS) staff to document how a local office handled a fair hearing decision.
TX HHS Form 5004. Optional COVID-19 CHIP Provider Co-payment Attestation
The TX HHS Form 5004, Optional COVID-19 CHIP Provider Co-payment Attestation, is a crucial document for healthcare providers to attest that they did not collect office visit co-pays from CHIP members during specified dates of service.
TX HHS Form 5005. What to Expect During Your Agency's Survey (HCSSA)
The TX HHS Form 5005, "What to Expect During Your Agency's Survey (HCSSA)", is a crucial document for Home and Community Support Services Agencies (HCSSA) in Texas.
TX HHS Form 5006. Application for Hardship Waiver
The TX HHS Form 5006, Application for Hardship Waiver, is a crucial document that helps individuals navigate the Medicaid Estate Recovery Program (MERP) when faced with an undue hardship.
TX HHS Form 5012. Contract Monitoring Visit Summary Report
The TX HHS Form 5012, Contract Monitoring Visit Summary Report, is a valuable tool for monitoring the performance of guardianship programs under contract with Texas Health and Human Services (HHS).
TX HHS Form 5014. Report of Death or Service Termination
The TX HHS Form 5014, Report of Death or Service Termination, is a crucial document that helps resolve the issue of reporting the termination of services or the death of an individual under the guardianship program.
TX HHS Form 5013. Contractor Referral
The TX HHS Form 5013, Contractor Referral, is a crucial document that helps solve the problem of identifying potential wards in need of guardianship services.
TX HHS Form 5020. Application for Texas Health Insurance Premium Payment (HIPP) Program
The Texas Health Insurance Premium Payment (HIPP) Program Application Form 5020 is a crucial document that helps individuals and families access affordable health insurance.