Get Consumer Enrollment (action Code L01) - Hhs Enterprise Portal

This guide provides a comprehensive overview of the process for completing the Consumer Enrollment (Action Code L01) form on the HHS Enterprise Portal. It is designed to assist users in navigating the various sections and fields of the form with ease.

Follow the steps to complete the Consumer Enrollment form online.

1. Press the ‘Get Form’ button to obtain the Consumer Enrollment form and open it in your preferred editing tool.
2. Begin by entering the required personal information in the designated fields. This includes your last name, first name, middle name, and client ID, as well as the local case number if applicable.
3. Next, select the waiver type by indicating either 1 for HCS or 4 for TXHML. Ensure you choose the correct option based on your situation.
4. Indicate the admission source by selecting the appropriate option: 1 for Community, 2 for ICF-MR, 3 for State School, 4 for Refinance, or 5 for State Hospital.
5. If applicable, specify whether you are participating in the Money Follows the Person Demonstration Project by answering with 'Y' for Yes or 'N' for No.
6. Provide information regarding prior discharge from a Medicaid certified nursing facility or ICF-MR by noting the slot type or tracking number.
7. Enter your county of service in the provided field.
8. If a guardian is involved, fill in their last name, first name, middle initial, and contact information, including the phone number and address details.
9. Finally, include the name of the person who completed the form, along with the date of completion.
10. Review all the entered information carefully. Once confirmed, save your changes, and choose to download, print, or share the form as needed.

Complete your Consumer Enrollment form online today to ensure a smooth and efficient process.