This version of the form is not currently in use and is provided for reference only. Download this version of Form 3613 for the current year.
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 3613 Provider Investigation Report?
A: Form 3613 Provider Investigation Report is a document used by Texas home health, hospice and personal assistance services providers for reporting provider investigations.
Q: What is the purpose of Form 3613 Provider Investigation Report?
A: The purpose of Form 3613 Provider Investigation Report is to document and report any investigations conducted by home health, hospice and personal assistance services providers in Texas.
Q: Who should use Form 3613 Provider Investigation Report?
A: Form 3613 Provider Investigation Report is only for use by home health, hospice and personal assistance services providers in Texas.
Q: Is a fax cover sheet required for Form 3613 Provider Investigation Report?
A: Yes, a fax cover sheet is required for submitting Form 3613 Provider Investigation Report.
Q: Can other types of providers use Form 3613 Provider Investigation Report?
A: No, Form 3613 Provider Investigation Report is specifically designed for home health, hospice and personal assistance services providers in Texas.
Form Details:
Download a fillable version of Form 3613 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.