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  • Tx Form 8493 2023

Get Tx Form 8493 2023-2026

E submitted to HHSC by fax or through the Salesforce provider portal, and the local intellectual and developmental disability authority by the end of the next business day after the program provider becomes aware of the death. To: HHSC Attention: Risk Assessment Coordinators Fax No.: 512-206-3999 Provider Name: Contract No.: Comp Code (HCS and TxHmL): Area Code and Phone No.: Area Code and Fax No.: Date Submitted to HHSC: Submitted by: Contact Name: Contact Phone No.: Contact Email A.

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How to fill out the TX Form 8493 online

This guide provides comprehensive and user-friendly instructions for completing the TX Form 8493 online. By following the steps outlined below, you will be able to fill out the necessary information accurately and efficiently in order to meet the reporting requirements for a death in home and community-based services.

Follow the steps to complete the TX Form 8493 online

  1. Press the ‘Get Form’ button to access the form and open it in the appropriate editor.
  2. Begin filling out the form by entering the provider name and contract number in the designated fields. Ensure that the information matches your official documentation.
  3. Include the service code and area code along with the phone number and fax number of the provider.
  4. Record the date when the form is submitted to HHSC. Be sure to provide the name of the person submitting the form, along with their contact phone number and email address.
  5. Enter the CARE ID number, date the provider was notified of the death, and the admission date to the provider.
  6. If applicable, specify the date of hospice involvement and the cause of death, if known.
  7. Select the type of residence and the type of death, indicating if it was expected, unexpected, or an accident.
  8. Fill in the date of death and provide details of any hospitalizations within the last three months.
  9. Indicate whether HHSC provider investigations have been notified by selecting ‘Yes’ or ‘No’.
  10. Enter the place of death and specify if an autopsy was performed, indicating ‘Yes’ or ‘No’.
  11. In the remaining section, briefly describe the events surrounding the death to provide context.
  12. Finally, ensure that any additional documents required for submission are prepared. This may include necessary plans, medication administration records, and nursing assessments.
  13. Once all fields are completed, you can save the changes, download the document, print it out, or share it as needed.

Complete the TX Form 8493 online today to ensure timely reporting.

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