Indigent Health Care
FOR ELIGIBILITY CONTACT:
For appointments contact:
Tammy Lawing & Martha Clement
903-428-8500
Billing Address:
County Auditor
200 N Walnut Street
Clarksville, TX 75426
All claims must be received within 95 days of the date of service. Claims must be submitted on the correct forms (CMS-1500 or UB-04). All providers must submit an up to date W-9 (linked below) to the Red River County Auditor's office every two years.
W-9
View Eligibility Criteria
Printable Forms: (click a link below)
Information Needed for Application
HIPPA Privacy Policy
IHCP Application
Fraud Policy
Release of Information Form