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Get Hhsc Form 7484

Hospital Report (Newborn Child or Children) HHSC Form 7484 MAIL FORM TO: Date Recd in Integrity Control Texas Health and Human Services Commission Data Integrity 952X PO BOX 149030 Austin TX 787149030.

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How to fill out the HHSC Form 7484 online

This guide provides a clear and user-friendly approach to completing the HHSC Form 7484, which is used to report the birth of a child to the Texas Health and Human Services Commission. Follow these steps to ensure a smooth submission process for the required documentation.

Follow the steps to complete your HHSC Form 7484 online.

  1. Press the ‘Get Form’ button to download the form and open it in your preferred online editor.
  2. Begin by entering the mother’s information. Fill in her name, admission date, mailing address, date of birth, Medicaid recipient number, and medical record number accurately to prevent any delays.
  3. Proceed to the child’s details. You can input the child's last name, first name, sex, date of birth, and medical record number for each child. If the first name is unknown, you may complete the last name field.
  4. Indicate whether the mother has relinquished her rights to the newborn child by selecting 'Yes' or 'No'. If you select 'Yes', please provide the date of relinquishment.
  5. Enter the attending physician's information along with their medical license number. Make sure to include the name of the hospital and its address.
  6. Finally, complete the section for who filled out the form and provide the hospital’s telephone number. Also, indicate the date the form is being mailed.
  7. Review all the entered information for accuracy. Once confirmed, save your changes, and choose to download, print, or share the completed form as needed.

Complete your HHSC Form 7484 online today to ensure timely processing of your newborn's Medicaid claims.

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To fill out a mail forwarding form, start by entering the current address and the new forwarding address. Ensure you comply with all instructions listed in the Hhsc Form 7484 to avoid delays in your mail delivery. Finally, confirm that all information is accurate before submitting the form.

The client information form typically asks for various details, including the client's personal information, service requests, and relevant historical data. In particular, the Hhsc Form 7484 may include specific questions tailored to your legal needs, ensuring you gather all essential information distinctly.

Documenting client information correctly requires attention to detail and adherence to privacy guidelines. Use clear handwriting or type the information electronically, as suggested by the Hhsc Form 7484. Always double-check for accuracy to prevent any issues that may arise from incorrect data.

Filling a client information form involves providing accurate and current details about your client. Begin by clearly labeling each section with appropriate headings, following the structure suggested in the Hhsc Form 7484. This approach ensures you capture all needed data without missing any important fields.

A client intake form typically requires basic personal information, such as the client's name, address, phone number, and email. Additionally, include any pertinent medical history or services requested. Make sure that you refer to the Hhsc Form 7484 for any unique information that may be required for your specific situation.

To fill out a client information form, start by gathering all necessary personal details from the client. Ensure you include their full name, contact information, and any relevant identification numbers. Follow the specific guidelines provided in the Hhsc Form 7484 document to maintain consistency and accuracy throughout the process.

Proof of income from your job – Last 3 pay stubs or paychecks, a statement from your employer, or self-employment records. Bank accounts – The most current statement for all accounts. Medical costs – Bills, receipts, or statements from health-care providers (doctors, hospitals, drug stores, etc.).

In Texas, there are 5 different types of Medicaid: Traditional Medicaid. STAR. STAR Kids. STAR Health. STAR+PLUS.

Forms FormTitleForm H1200-PFSTitle Medicaid Application for Assistance (for Residents of State Facilities) Property and Financial StatementForm H1201Title MAO WorksheetForm H1201-ATitle Client Declaration or Streamline Review WorksheetForm H1201-EZTitle Medicaid Eligibility Client Declaration Worksheet145 more rows

To get Medicaid, you must be a Texas resident and a U.S. citizen or qualified non-citizen. When you apply, we'll ask about your income, your age, and your disability status to see if you qualify.

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© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232