Form 3618 Required for All Resident Transactions (Admissions and Discharges)

 

This letter is a reminder that NFs must submit Texas Department of Aging and Disability Services (DADS) Form 3618, Resident Transaction Notice, within 72 hours of an admission or discharge (transaction).

After completion, Form 3618, Resident Transaction Notice can only be submitted electronically on the Texas Medicaid & Healthcare Partnership (TMHP) Long Term Care (LTC) Portal. Nursing Facility providers should review Texas Administrative Code (TAC) §19.2615, Resident Transaction Notice:

A nursing facility must electronically submit to the state Medicaid claims administrator a resident transaction notice within 72 hours after a recipient’s admission or discharge from the Medicaid nursing facility vendor payment system. The nursing facility administrator must sign the resident transaction notice.

Nursing Facility providers have a contractual responsibility to report admissions and discharges via Form 3618, Resident Transaction Notice, and not to submit a claim for services when a Medicaid client has left their facility. Billing for days the individual is not in the facility could result in a referral to the Office of the Inspector General for fraudulent billing.

Section I of the NF provider agreement states the nursing facility:

…provider agrees to the terms and conditions set forth below (as found in the actual contract) and to the provisions of the Nursing Facility Requirements for Licensure and Medicaid Certification (NFR/LMC) published by the Department, a copy of which has been furnished to the Facility and which is hereby incorporated by reference as a part of this contract.

Timely and accurate submission of Form 3618, Resident Transaction Notice, benefits providers by updating the payment system to reflect appropriate service dates and resident eligibility. Documentation of these transactions allow the consumer’s new service provider to admit and bill for the current services. In addition, submission within 72 hours facilitates timely payments to residents who are eligible for Personal Needs Allowance benefits.

Providers who do not submit and process Form 3618, Resident Transaction Notice as required are out of compliance with their contract and subject to adverse action, including vendor holds.