Please Print, Complete and Fax to: 1-832-237-1042

Thank you for giving National Cost Report the opportunity to provide you with a proposal for our Texas Medicaid cost report preparation services. We have over 30 years experience in Texas Medicaid cost reporting.

Preparation of one (1) Texas Medicaid Nursing Facility Cost Report………………..…..$ 2,250.00

What this includes: The compilation and review of your Texas Medicaid cost report, along with supplementary schedules, as may be required by the Texas Health and Human Services Commission. Each report will be completed in the ACRES software, by certified preparers, in compliance with promulgated HHSC specific instructions and cost finding rules and regulations. Pending timely receipt of requested financial and other statistical information, the completed cost reports will be submitted to you for review and certification prior to their due date. This service includes the answering of desk review and field review questions.

Fees are exclusive of any travel costs.

Should an ownership change occur during this contract period, the entire contract fee is due and payable.

I have received the above proposal and acknowledge that it is acceptable. I hereby request and authorize the National Cost Report to begin work immediately on the items noted above. If this bid is acceptable, please sign below and fax to our Houston office at 832-237-1042.

Upon fax receipt of signed contract, we will fax you our Texas Medicaid Cost Report information request packet.

Sincerely,

John E. Peterson, Jr.
CPA