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AI- 94744
Health & Human Services Dept.   15.B.
CC REGULAR AGENDA SPECIAL MTG
Meeting Date:
04/02/2024
Submitted For:
Eddie Olivarez
Submitted By:
Mike Escaname
Department:
HEALTH & HUMAN SERVICES DEPT.

CAPTION

Pursuant to Texas Local Government Code Section 157.903, requesting approval of indemnification in the amount of $40.00 as a result of clerical errors regarding health service fees.  

BACKGROUND

03/05/2024 - Receipt No. 103085 - Client was undercharged $5.00 per vaccine for two vaccines; Total = $10.00
03/25/2024 - Receipt No. 103191 - Client was undercharged $30.00 as a result of using an incorrect encounter form.  Total = $30.00

Fiscal Impact

CALENDAR YEAR:
2024
ACCT. #:
4-1100-441-00-340-001-0-890
FUNDS AVAILABLE Y/N?:
Y
MATCHING FUNDS Y/N?:
N

BUDGETARY IMPACT:

03/05/2024 - Receipt No. 103085 - Client was undercharged $5.00 per vaccine for two vaccines; Total = $10.00
03/24/2024 - Receipt No. 103191 - Client was undercharged $30.00 as a result of using an incorrect encounter form; Total = $30.00

Attachments

Form Review

Inbox Reviewed By Date
Budget and Management Veronica Ortiz 03/28/2024 09:57 AM
Final Approval Monica Salinas 03/28/2024 04:50 PM
Form Started By:
Mike Escaname
Started On:
03/27/2024 08:08 AM
Final Approval Date:
03/28/2024