Appendices
Appendix I, Helpful Telephone Numbers
Revision 08-1; Effective November 12, 2008
CARE Form System (3618, 3619, and 3652) | 800-727-5436 |
Distribution (fax) | 512-438-3548 |
Facility Enrollment | 512-438-2630 |
Hospice Complaints | 800-458-9858 |
ICF/MR-RC Complaint Hotline | 800-458-9858 |
Medicaid Fraud | 888-752-4888 |
Medicaid Hospice | 512-438-3015 |
Nursing Home Hotline | 800-458-9858 |
Protective and Regulatory Hotline (PRS) | 800-252-5400 |
Provider Claims Services | 512-438-2200 |
Texas Medicaid and Healthcare Partnership-Long Term Care | 800-626-4117 |
Vendor Drug Hotline | 800-435-4165 |
Appendix II, Abbreviations Dictionary
Revision 08-1; Effective November 12, 2008
AI | Applied Income |
CCAD | Community Care Aged and Disabled |
CFR | Code of Federal Regulations |
CM | Contract Management |
CMS | Claims Management System |
DADS | |
DME | Durable Medical Equipment |
DSHS | Texas Department of State Health Services |
HHSC | Texas Health and Human Services Commission |
ICF-MR/RC | Intermediate Care Facilities for Persons with Mental Retardation and Related Conditions |
MAO | Medical Assistance Only |
MDS | Minimum Data Set |
ME | Medicaid Eligibility |
MED | Medicaid Eligibility Date |
NF | Nursing Facility |
PIN | Payee ID Number (14 digits) |
RUG | Resource Utilization Group |
SSA | Social Security Administration |
SSI | Supplemental Security Income |
TMHP | Texas Medicaid and Healthcare Partnership |
UR | Utilization Review |
Appendix III, Directive to Physicians and Family or Surrogates
Revision 05-1; Effective December 2, 2005
Visit the web site below for this information:
Appendix IV, Disclosure Statement for Medical Power of Attorney
Revision 05-1; Effective December 2, 2005
Disclosure Statement for Medical Power of Attorney:
https://hhs.texas.gov/laws-regulations/forms/miscellaneous/mpoa-medical-power-attorney
Visit the web site below for additional information:
https://hhs.texas.gov/laws-regulations/forms/advance-directives
Appendix V, Out of Hospital Do Not Resuscitate Order
Revision 05-1; Effective December 2, 2005
For information about the Texas Department of State Health Services Out of Hospital Do Not Resuscitate Program and forms, visit the web site at http://www.dshs.texas.gov/emstraumasystems/dnr.shtm.