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Fill Your Texas 1745 Form

The Texas 1745 form is a Service Delivery Log used for documenting hours worked in the Consumer Directed Services program. This form is essential for ensuring accurate reporting of services provided to individuals with disabilities. Timely submission of the form is critical to avoid delays in payment for services rendered.

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Dos and Don'ts

When filling out the Texas 1745 form, it's essential to follow specific guidelines to ensure accuracy and compliance. Here’s a helpful list of dos and don’ts:

  • Do fill out all required fields completely to avoid delays.
  • Do ensure that the service dates are accurate and match the actual services provided.
  • Do sign the time sheet only after the work has been completed.
  • Do submit the time sheet by the specified deadlines to ensure timely payment.
  • Don't submit advance time sheets; they will not be accepted.
  • Don't leave any fields blank; incomplete forms can lead to processing issues.
  • Don't falsify any information on the form, as this could result in serious consequences.
  • Don't forget to keep a copy of the submitted time sheet for your records.

Sample - Texas 1745 Form

Alamo Consumer Direct

Consumer Directed Services

Texas Department of Aging

Phone: 5124200832, Toll Free: 18779030832

Service Delivery Log with Written

and Disability Services

Toll Free Fax: 18776520877

Narrative/Written Summary

Form 1745compliant

8701 Shoal Creek Blvd, Suite 303

 

 

Austin TX 787576809

 

 

Employee Name

Consumer Name

Time sheet due date: If faxed or dropped off, time sheets are due at the Consumer Direct office by Monday (at midnight) following the week of service. If mailed, they must be postmarked by Monday following the week of service. Late time sheets will result in late pay.

Check Program: DBMD CBA CLASS HCS PCS PHC TXHML

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Service Date

(mm/dd/yy)

Service Code

Time In

Time Out

Time In

Time Out

Time In

Time Out

Daily Total

NOTE: Time sheets must be signed AFTER the work is completed. Advance time sheets will not be accepted. Total Weekly Hours

Service Date

(mm/dd/yy)

Place of Service

Written Narrative/Summary

Employee/Consumer: I certify that the work hours listed above are accurate, and that services were provided in accordance with the Employee Work Schedule and Assigned Tasks (DADS 1731). I understand that falsification of this time sheet is considered Medicaid Fraud and may result in dismissal from the program and criminal prosecution.

Employee Signature

Date

Consumer Signature

Date

02052

REV. 06/27/2013

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Documents used along the form

When working with the Texas 1745 form, which is primarily used for documenting service delivery in consumer-directed services, several other forms and documents often accompany it. Each of these documents plays a crucial role in ensuring compliance, tracking services, and managing payments effectively. Below is a list of related forms that you may encounter.

  • Employee Work Schedule (DADS 1731): This document outlines the specific tasks and hours assigned to an employee providing services. It ensures that both the employee and the consumer are aware of the expectations and responsibilities.
  • Service Delivery Log: This log is used to track the daily services provided to a consumer. It includes details such as the type of service, duration, and any notes relevant to the service delivery.
  • Time Sheet: Similar to the Texas 1745 form, the time sheet records the hours worked by an employee. It is crucial for payroll processing and must be submitted in a timely manner to avoid payment delays.
  • Consumer Directed Services (CDS) Enrollment Form: This form is used to enroll a consumer in the CDS program. It collects essential information about the consumer and their needs, ensuring they receive appropriate services.
  • Provider Agreement: This document establishes the relationship between the consumer and the service provider. It outlines the terms and conditions under which services will be delivered.
  • Service Plan: A service plan details the specific services that will be provided to the consumer. It is developed collaboratively and reflects the consumer’s preferences and needs.
  • Incident Report: If any issues arise during service delivery, an incident report is used to document the situation. This ensures that any problems are addressed and can help prevent future occurrences.
  • Consumer Satisfaction Survey: This survey is used to gather feedback from consumers about the services they receive. It helps improve service quality and ensures that consumer needs are being met.
  • Authorization for Release of Information: This form allows the sharing of a consumer’s personal information with relevant parties, ensuring compliance with privacy laws while facilitating communication among service providers.
  • Payment Authorization Form: This document authorizes payments to be made for services rendered. It is essential for ensuring that employees are compensated for their work.

Understanding these documents and their purposes can greatly enhance the efficiency of service delivery in consumer-directed services. By ensuring that all necessary forms are completed and submitted correctly, consumers and employees alike can focus on providing and receiving quality care.

Common mistakes

Filling out the Texas 1745 form can be straightforward, but many people make common mistakes that can lead to delays or issues with payment. One frequent error is not signing the time sheet after the work is completed. It's essential to remember that signatures should only be added once services have been rendered. Advance signatures can result in the form being rejected, causing frustration and potential delays in payment.

Another mistake often seen is failing to accurately record the service dates. Each entry should reflect the correct date of service in the mm/dd/yy format. If the dates are incorrect, it can complicate the processing of the time sheet and lead to confusion regarding when services were actually provided.

Many individuals also overlook the importance of providing the correct service codes. Each service has a specific code that must be included on the form. Using an incorrect code can lead to payment issues, as it may not align with the services rendered.

In addition, some people forget to include the total weekly hours at the end of the form. This total is crucial for processing payments accurately. Without this information, the time sheet may be considered incomplete, resulting in further delays.

Another common pitfall is not adhering to the submission deadlines. If you are faxing or dropping off the time sheet, it must be submitted by midnight on the Monday following the week of service. If mailing, the form must be postmarked by that same Monday. Late submissions can lead to late payments, which can be frustrating.

Additionally, some individuals neglect to provide a detailed narrative or summary of the services provided. This section is important for clarity and helps ensure that all parties understand the services rendered. A lack of detail can lead to questions or disputes down the line.

People also sometimes forget to check the program box. The Texas 1745 form requires you to indicate which program you are participating in, such as DBMD or CLASS. Failing to do this can lead to processing errors.

It's also crucial to ensure that both the employee and consumer signatures are included on the form. Omitting one of these signatures can result in the form being deemed invalid. Each signature confirms that the information provided is accurate and complete.

Lastly, individuals may not keep copies of their submitted time sheets. It’s always a good idea to retain a copy for your records. This can be helpful if there are any questions or disputes regarding the submitted hours or services.

By being aware of these common mistakes and taking steps to avoid them, you can help ensure a smoother process when filling out the Texas 1745 form. Proper attention to detail can make a significant difference in receiving timely payments for services rendered.

Misconceptions

Misconceptions about the Texas 1745 form can lead to confusion and potential issues with service delivery. Below are ten common misconceptions, along with clarifications for each.

  1. All time sheets can be submitted at any time. Time sheets must be submitted by specific deadlines. If faxed or dropped off, they are due by Monday at midnight following the service week. Mailed time sheets must be postmarked by the same Monday.
  2. Late submissions are acceptable. Late time sheets will result in late pay. It is crucial to adhere to the submission deadlines to ensure timely compensation.
  3. Time sheets can be signed before services are rendered. Time sheets must be signed only after the work is completed. Signing in advance is not permitted and can lead to complications.
  4. All service codes are the same. Different programs have unique service codes. It is essential to select the correct code that corresponds to the service being provided.
  5. Falsifying time sheets has no serious consequences. Falsification is considered Medicaid Fraud. This can lead to dismissal from the program and potential criminal prosecution.
  6. Written narratives are optional. A written narrative or summary is required as part of the documentation process. This ensures clarity and accountability in service delivery.
  7. Time sheets do not require consumer verification. Both the employee and consumer must sign the time sheet. This verification is necessary to confirm that services were provided as stated.
  8. Only one signature is needed. Both the employee and the consumer must sign the time sheet. This dual signature process is vital for compliance.
  9. All services can be documented on a single line. Each service provided should be documented separately, including time in and time out for accurate record-keeping.
  10. There are no consequences for missing the time sheet deadline. Missing deadlines can lead to delays in payment. It is important to be diligent about submission timelines.

Understanding these misconceptions can help ensure compliance with the Texas 1745 form requirements and promote smoother service delivery.

Key takeaways

Here are some key takeaways about filling out and using the Texas 1745 form:

  • Submission Deadlines: Time sheets must be submitted by Monday at midnight if faxed or dropped off. If mailed, they need to be postmarked by the same day.
  • Late Submissions: Submitting time sheets late can lead to delayed payments for services rendered.
  • Service Codes: Ensure you check the appropriate program box, such as DBMD, CBA, CLASS, HCS, PCS, PHC, or TXHML.
  • Accurate Reporting: Time sheets must reflect actual hours worked. Falsifying information can lead to serious consequences, including criminal prosecution.
  • Signature Requirement: Time sheets must be signed only after the work is completed. Advance signatures are not accepted.
  • Contact Information: For questions or assistance, reach out to the Texas Department of Aging at 512-420-0832 or toll-free at 1-877-903-0832.

File Characteristics

Fact Name Description
Form Purpose The Texas 1745 form is used for documenting service delivery in Consumer Directed Services.
Governing Law This form is governed by the Texas Health and Safety Code, particularly sections related to Medicaid and consumer-directed services.
Submission Deadline Time sheets are due by Monday at midnight if faxed or dropped off. Mailed sheets must be postmarked by the same deadline.
Late Submission Consequences Late time sheets will result in delayed payment for services rendered.
Service Codes Various service codes are available, including DBMD, CBA, CLASS, HCS, PCS, PHC, and TXHML.
Signature Requirement Time sheets must be signed after the work is completed. Advance time sheets are not accepted.
Accuracy Certification Employees must certify the accuracy of the reported hours, acknowledging that falsification is considered Medicaid Fraud.
Contact Information The Texas Department of Aging can be reached at 512-420-0832 or toll-free at 1-877-903-0832.
Location The form is associated with the Texas Department of Aging, located at 8701 Shoal Creek Blvd, Suite 303, Austin, TX 78757-6809.

How to Use Texas 1745

Completing the Texas 1745 form requires attention to detail and accuracy. This form is essential for documenting services provided under various programs. Follow the steps outlined below to ensure you fill it out correctly.

  1. Begin by entering the Employee Name and Consumer Name at the top of the form.
  2. Identify the Time Sheet Due Date. Remember, if faxed or dropped off, it is due by midnight on the following Monday. If mailed, ensure it is postmarked by that date.
  3. Select the appropriate Check Program by marking the corresponding box. Options include DBMD, CBA, CLASS, HCS, PCS, PHC, and TXHML.
  4. For each day of the week, fill in the Service Date in the format mm/dd/yy.
  5. Enter the Service Code for each service provided.
  6. Record the Time In and Time Out for each service session. If multiple sessions occur in a day, list them separately.
  7. Calculate and fill in the Daily Total hours worked for each day.
  8. At the end of the week, sum up the Total Weekly Hours worked.
  9. Indicate the Place of Service where the services were provided.
  10. Write a Written Narrative/Summary of the services provided during the week.
  11. Both the employee and consumer must sign the form. The Employee Signature and Consumer Signature must be dated.