Revision 19-3; Effective July 1, 2019
All Programs
Applicant Data |
- Name
- SSN*
- Social Security Claim Number (SSCN or PCN)*
- Date of Birth
- Sex
|
- HHSC County Code
- Category Code
- Application Number
- Application Disposition Date
- Application Status
- Client Number
|
Client Data |
- Name
- Client Number
- SSN*
- SSCN*
- Date of Birth
- Sex
- HHSC County Code
- Certification Date
- Claims Administrator Update Date (Ins Sub Date)
- Last Medical Update Date
- Code for Type Change in Medical Coverage
- Medicaid:
- Open Date
- Close Date
- Type Coverage
- Category
- Type Program
- Qualified Medicare Beneficiary (QMB) Indicator, if applicable
- Medically Needy Indicator, if applicable
- Client Medical Record
- Case Numbers (active)
|
- Third-Party Resource (TPR) Policy Occurs (most recent three):
- Ins. Policy Number
- Ins. Policy Sequence
- Ins. Information Status
- Type Coverage
- Company Number
- Group Number
- Ins. Begin Date
- Ins. End Date
- Ins. Policy Holder
- Ins. Employer
- Medicare (Yes or No)
- Texas Health Steps Data:
- Texas Health Steps Decision Date
- Dental Treatment Date
- Medical Screen Date
- Lock-in Data (most recent six):
- Provider Type
- Provider Name
- Start Date
- Through Date
|
Public Assistance (PA) Case Data |
- Case Number
- Eligibility Determination Group (EDG) Number
- Case Name
- Case Status
- Three Month Prior Date
- End Date (For Medically Needy)
- Denial Reasons **
|
- Type Program
- Active Clients List:
- Client Number
- Name
- Date of Birth
- Sex
- Three Months Prior with Spend Down (not the spend down amount)
|
* Staff must confirm that the number given by the requestor is correct. Staff do not release Social Security numbers.
** Only the following denial reasons can be released:
Reason |
Refusal to furnish information |
Failure to furnish information |
Appointment not kept (application/review) |
Unable to locate |
Voluntary withdrawal |