Texasftadmin2020-11-13T13:40:30-07:00

Texas

Texas

Important Notice: EVV State Deadline is 1/1/2021

98.8% Customer Satisfaction Average for 2020

To contact Acumen Fiscal Agent, please call (866) 759-9524 or fax (855) 264-3287.

CLASS
DBMD
HCS
PCS
PHC
STAR Kids
STAR+PLUS
TXHML

CLASS

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX CLASS Employee Enrollment Packet
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX Payment Schedule
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

DBMD

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX DBMD Employee Enrollment Packet
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX Payment Schedule
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

HCS

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX HCS Employee Enrollment Packet
TX Payment Schedule
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

PCS

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX PCS Employee Enrollment Packet
TX Payment Schedule
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

PHC

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX PHC Employee Enrollment Packet
TX Payment Schedule
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

STAR Kids

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX Payment Schedule
TX STAR Kids Employee Enrollment Packet
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

STAR+PLUS

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX Payment Schedule
TX STAR PLUS Employee Enrollment Packet
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form

TXHML

Program Website
Consumer Directed Services Employer Handbook

Participant Employer Forms

Form W-9
TX Client & Employer Change Information Form
TX Compensation Request Form
TX Employee Termination Form
TX Form 1723 EVV Request for Employer Phone Numbers
TX Payment Schedule
TX TXHML Employee Enrollment Packet
TX Vendor Payment Request Form

Direct Care Employee Forms

Form W-4
TX Employee Change Information Form
TX Pay Selection & Direct Deposit Form