TX HHS Form 3083. Optional Health Care Services Notification
The TX HHS Form 3083, Optional Health Care Services Notification, is a crucial document that helps counties in Texas notify the state of their optional health care services.
TX HHS Form 3084. Employment Verification
The TX HHS Form 3084, Employment Verification, helps determine the eligibility of a household applying for health care assistance from the County Indigent Health Care Program (CIHCP). This form is used to verify all earnings of an individual who is, was, or will be employed by another person.
TX HHS Form 3085. Statement of Self-Employment Income
The TX HHS Form 3085, Statement of Self-Employment Income, is a crucial document for individuals who earn income through self-employment. This form helps solve the problem of accurately reporting self-employment income to the County Indigent Health Care Program (CIHCP).
TX HHS Form 3086. End of Year Report
Form 3086 is the official End of Year Report used by entities participating in the Texas County Indigent Health Care Program (CIHCP).
TX HHS Form 3087. TMHP Confidentiality Agreement
The TX HHS Form 3087, TMHP Confidentiality Agreement, is a crucial document that ensures the confidentiality, integrity, and continuity of information resources for the County Indigent Health Care Program (CIHCP).
TX HHS Form 3088. Request for State Assistance Funds (90 Percent)
The TX HHS Form 3088, Request for State Assistance Funds (90 Percent), is a crucial document that helps healthcare providers request reimbursement from the Texas Health and Human Services (HHS) for health care services provided under the County Indigent Health Care Program.
TX HHS Form 3092. Medication Administration Record
The TX HHS Form 3092, Medication Administration Record, is a practical tool designed to help healthcare professionals accurately track and record medication administration for patients.
TX HHS Form 3094. Application for Program Benefits
The TX HHS Form 3094, Application for Program Benefits, is a crucial document that helps individuals apply for healthcare assistance through the Epilepsy Program. This form can be completed by anyone seeking benefits, including those who are applying on behalf of a child.
TX HHS Form 3093. KHC Travel Claim for Home Dialysis and Kidney Transplant Patients
The TX HHS Form 3093, KHC Travel Claim for Home Dialysis and Kidney Transplant Patients, is a crucial document that helps individuals with end-stage renal disease or kidney transplants track and claim mileage reimbursement for medical-related travel.
TX HHS Form 3082. Notice of Ineligibility
The TX HHS Form 3082, Notice of Ineligibility, is a crucial document for individuals who have applied for County Indigent Health Care Program (CIHCP) benefits but have been denied.