Government Relations Archives

12212020_AccessTransgenderServices_Fax
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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12212020_Auth_Process_Update_Fax_Email
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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12Tips-Working-With-Interpreter
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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2020_PTA_ABCQI_Charter_Fillable
Amit Karkhanis, Naomi Kawabata, Pending 2024 Review, Veronica Lozano
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2020_PTA_ABCQI_Charter_Sample
Amit Karkhanis, Naomi Kawabata, Pending 2024 Review, Veronica Lozano
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2020_PTA_ABCQI_SMART_Activity
Amit Karkhanis, Naomi Kawabata, Pending 2024 Review, Veronica Lozano
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20201216_321570-H_Pfizer_StandingOrders-319pm
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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20201216_321629-E_VTF_ScreenChecklistContraPrec
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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2021-Provider-Satisfaction-Survey-Executive-Summary
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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2022 CBI Workshop Webinar Slides
Kristen Rohlf, Pending 2024 Review
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2022 Facility Site Review (FSR) Tool Effective July 1 2022
DeAnna Leamon, Pending 2024 Review
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2022 Medical Record Review (MRR) Tool effective July 1, 2022
DeAnna Leamon, Pending 2024 Review
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2022_FSR Provider Check List_final
DeAnna Leamon, Pending 2024 Review
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2022_MRR Provider Check List_final
DeAnna Leamon, Pending 2024 Review
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2022_Provider_Workbook_Final
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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2023 Medi-Cal EOC with cover
Megan Sims, Pending 2024 Review
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2023_Medi-Cal EOC_Final_Hmong_web
Megan Sims, Pending 2024 Review
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2023_Medi-Cal_EOC_Sp
Megan Sims, Pending 2024 Review
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2023-CBI-Workbook-Final
Britta Vigurs, Hilary Gillette-Walch, Kristen Rohlf, Pending 2024 Review
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2023-CBI-Workshop-Webinar-FAQs
Britta Vigurs, Hilary Gillette-Walch, Kristen Rohlf, Pending 2024 Review
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2023-CBI-Workshop-Webinar-Slides
Britta Vigurs, Hilary Gillette-Walch, Kristen Rohlf, Pending 2024 Review
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2024 CBI Workbook_Final
Britta Vigurs, Georgia Gordon, Pending 2024 Review
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2024 CBI Workshop Webinar FAQs
Britta Vigurs, Georgia Gordon, Pending 2024 Review
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2024 CBI Workshop Webinar Slides_10-04-2023
Britta Vigurs, Georgia Gordon, Pending 2024 Review
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2R_Minors-Rights-Statement
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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401-F-CBI-MMA-H-V4
Kristen Rohlf, Pending 2024 Review
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401-F-CBI-MMA-S-V4
Kristen Rohlf, Pending 2024 Review
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401-F-CBI-MMA-V4
Hilary Gillette-Walch, Kristen Rohlf, Pending 2024 Review
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405-F-CM-InterpreterRequest_V3_Fillable
Desirre Herrera, Pending 2024 Review
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Interpreter Services Quality Assurance Form

405-F-CM-ISQA-V1_Fillable
Desirre Herrera, Pending 2024 Review
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405-F-CM-Referral-V1_Fillable
Jennifer Mockus, Julie Norton, Pending 2024 Review
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ABCQI_EP_3_Process_Maps_Resources_Final
Amit Karkhanis, Naomi Kawabata, Pending 2024 Review, Veronica Lozano
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Addressing-Food-Insecurity_Final
Cori Lambert, Jessica Finney, Pending 2024 Review
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Addressing-Housing-and-Health_Final
Cori Lambert, Jessica Finney, Pending 2024 Review
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AdvanceDirective_Eng
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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AdvanceDirective_Span
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Alliance Code of Conduct
Pending 2024 Review, Rebecca Seligman
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Alliance Compliance Plan
Pending 2024 Review, Rebecca Seligman
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Alliance-Benefits-Guide-2024
Daryl Von Haunalter, Pending 2024 Review
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Alliance-EDI-Companion-Guide-270-271-Information
Kim McNeely, Pending 2024 Review
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Alliance-EDI-Companion-Guide-276-277-Information
Kim McNeely, Pending 2024 Review
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Alliance-EDI-Companion-Guide-Trading-Partner-Information
Kim McNeely, Pending 2024 Review
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Alliance-EDI-Companion-Guide-Transaction-Instruction
Kim McNeely, Pending 2024 Review
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Alliance-Provider-Directory-API-Documentation
David Davison, Pending 2024 Review
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Allied_Credentialing_Application
Jessie Dybdahl, Pending 2024 Review
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AUTH_STATUS_REQUEST
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Authorization for Behavioral Health Provider and Primary Care Provider to Share Confidential Information
Pending 2024 Review, Rebecca McMullen
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Authorization for Provider to Release Confidential Information to Carelon Behavioral Health
Pending 2024 Review, Rebecca McMullen
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AUTORIZACIÓN DEL MIEMBRO PARA UTILIZAR O REVELAR INFORMACIÓN MÉDICA PROTEGIDA
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Beacon_CCAH_PCP_Referral_Form
Pending 2024 Review, Shaina Zurlin
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BHO-Autism-Screening
Jennifer Mockus, Julie Norton, Pending 2024 Review
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Blood_Lead_Testing_Flyer
Desirre Herrera, Pending 2024 Review
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Breastfeeding_Benefit_Description
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Carelon-Behavioral-Health-of-California-Authorization-to-Release-Confidential-Information-Spanish
Pending 2024 Review, Rebecca McMullen
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CBAS_Inquiry_Form
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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CBI Benchmarks_Perf Improv_FINAL (2)
CJ Vansant, Pending 2024 Review
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CBI Benchmarks_Perf_Improv
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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CBI-Tech-Specs
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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cbi-tech-specs_2024
Kristen Rohlf, Pending 2024 Review
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CCAH_Data_Submission_Guide
Joana Castaneda, Pending 2024 Review
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CE Standards_2022
Leslie Stucky, Pending 2024 Review, Tisha Criswell
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Certification_Debarment
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Certification_Regarding_Lobbying
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Chemotherapy_Injectables_Prior_Authorization_Information Request
Navneet Sachdeva, Pending 2024 Review, Yasuno Sato
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Child_and_Adult_IZ_QI_Postcard
Kristen Rohlf, Pending 2024 Review
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Medi-Cal Capacity Grant Program Impact Report 2020

COM_2020-impact-report
Cori Lambert, Jessica Finney, Pending 2024 Review
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COM_2021-Impact-Report_pages
Cori Lambert, Jessica Finney, Pending 2024 Review
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CORP_Delegation-Model_D_EN
Pending 2024 Review, Rebecca Seligman
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CORP_health-equity_booklet-web
Pending 2024 Review
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CORP_Procedure-Code-Lookup-Tool-Job-Aid_D_EN
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Corrected_Claim_Form
Pending 2024 Review, Sharlene Gianopoulos
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Covered_Benefits_Matrix_EN
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Covered_Benefits_Matrix_HM
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Covered_Benefits_Matrix_SP
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Credit_Balance_Report
Kay Lor, Pending 2024 Review
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Daim Ntawv Foos Thov Them Nyiaj Rov Qab Rau Tus Tswvcuab
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Daim Ntawv Foos Thov Tus Kheej Rau Ib Tus Neeg Sawv Cev
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Data Collection Plan
Naomi Kawabata, Pending 2024 Review
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Depression_Toolkit
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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ECM Learning Session 1 Monterey County
Jennifer Mockus, Pending 2024 Review
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ECM Learning Session 1 Santa Cruz County
Jennifer Mockus, Pending 2024 Review
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ECM_Webinar Day in the LIfe-Practical Tips
Jennifer Mockus, Pending 2024 Review
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ECM_Webinar1_ECM101
Jennifer Mockus, Pending 2024 Review
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ECM_Webinar2_ECMAssessment
Jennifer Mockus, Pending 2024 Review
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ECM-CS-Bootcamp-Back-to-Basics-Training
Pending 2024 Review, Valda Wythe
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EDI_Claims_Enrollment_Form_INSTRUCTIONS
Kim McNeely, Pending 2024 Review
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EDI-Claims-Enrollment-Form
Kim McNeely, Pending 2024 Review
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Enterprise_Systems_List
Jenifer Mandella, Kat Reddell, Nicole Krupp, Pending 2024 Review
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Examples_Project_Objectives_Activities_and_Measurements
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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Exhibit_U-1-SBC-IHSS-2018
Megan Sims, Pending 2024 Review
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Exhibit_U-1-SBC-IHSS-2018_SP
Megan Sims, Pending 2024 Review
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F SporeTestingJobAid_FINAL
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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FAQ_HEDIS
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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Flow process chart directions
Amit Karkhanis, Britta Vigurs, Pending 2024 Review
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Formulario de Reclamo de Reembolso para Miembros
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Formulario de Solicitud de un Representante Personal
Megan Sims, Pending 2024 Review, Yomayra Gomez
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formulary
Navneet Sachdeva, Pending 2024 Review, Yasuno Sato
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A to Z Glossary of Spanish & Hmong Terms.

Glossary_of_Terms
Desirre Herrera, Pending 2024 Review
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Grievance Packet FAQ_NDN TAG Form HM_v082021

Grievance Packet FAQ_NDN TAG Form HM_v082021
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Grievance Packet FAQ_NDN TAG Form_SP_v082021

Grievance Packet FAQ_NDN TAG Form_SP_v082021
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Grievance Packet-FAQ_NDN TAG Form ENG_v082021
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Grievance_Tracking
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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HealthEducation-DiseaseManagementForm_v1
Hilary Gillette-Walch, Kristen Rohlf, Pending 2024 Review
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IBCLC_Consultants_and_Vendor_List
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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ID_of_Overpayment_Form
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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IHSS_EOC_ENG
Megan Sims, Pending 2024 Review
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IHSS_EOC_SP
Megan Sims, Pending 2024 Review
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IncentiveSummary_Final
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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Instructions_for_Budget_Narrative
Cori Lambert, Pending 2024 Review
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KK-Complaint-and-Appeal-Form_ENG_v072021
Pending 2024 Review, Sarah Sanders
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KK-Complaint-and-Appeal-Form_SP_v072021
Pending 2024 Review, Sarah Sanders
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Locum_Tenens_Notification
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Long Term Support Services
Melissa Kelly-Ortega, Pending 2024 Review
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Long_Term_Care_Treatment_Authorization_Request
Pending 2024 Review, Tammy Brass
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LTSS Liaison contact information
Melissa Kelly-Ortega, Pending 2024 Review
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MC-Complaint-and-Appeal-Form_ENG_v072021
Pending 2024 Review, Sarah Sanders
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MC-Complaint-and-Appeal-Form_HMG_v072021
Pending 2024 Review, Sarah Sanders
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MC-Complaint-and-Appeal-Form_SP_v072021
Pending 2024 Review, Sarah Sanders
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Medi-Cal Capacity Grant Program Impact Report 2019

MCGP_ImpactReport_2020-web
Cori Lambert, Jessica Finney, Pending 2024 Review
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Medi-Cal_Diagnostic_Evaluation
Pending 2024 Review, Rebecca McMullen
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Medical_Clearance_for_Dental_Anesthesia
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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MEM_2021-website-launch_F_ENG
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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MEM_2021-website-launch_F_HM
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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MEM_2021-website-launch_F_SP
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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MEM_IHSS-Benefit-Matrix_SP
Megan Sims, Pending 2024 Review
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MEM_IHSS-Benefits-Matrix_EN
Megan Sims, Pending 2024 Review
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MEM_Member-Incentives_13yr-Olds_E
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_13yr-Olds_HM
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_13yr-Olds_SP
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_2yr-Olds_E
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_2yr-Olds_E
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_2yr-Olds_HM
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_2yr-Olds_HM
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_2yr-Olds_SP
Desirre Herrera, Pending 2024 Review
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MEM_Member-Incentives_2yr-Olds_SP
Desirre Herrera, Pending 2024 Review
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MEM_Online-Provider-Directory-Tutorial_ENG
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Member Reimbursement Claim Form
Megan Sims, Pending 2024 Review, Yasuno Sato
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Member_Appt_No_Show_Notification
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Member_Services_Advisory_Group_Application_EN
Kayla Zoliniak, Pending 2024 Review
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Member Services Advisory Group Application Hmong

Member_Services_Advisory_Group_Application_HM
Kayla Zoliniak, Pending 2024 Review
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Member Services Advisory Group Application Spanish

Member_Services_Advisory_Group_Application_SP
Kayla Zoliniak, Pending 2024 Review
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MEMBER’S AUTHORIZATION TO USE OR DISCLOSE PROTECTED HEALTH INFORMATION
Megan Sims, Pending 2024 Review, Yomayra Gomez
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MNT_Quick_Reference_Guide
Hilary Gillette-Walch, Pending 2024 Review
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New_Non_PCP_Training
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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New_Provider_Training
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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New-Provider-ECM-Community-Supports-Training-Sign-Off-Form
Jennifer Mockus, Pending 2024 Review
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Notice of Intent-Amend – CCAH – 2024
Evan Eurs, Pending 2024 Review
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Notice-of-Nondiscrimination-and-Accessibility
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Notice-of-Nondiscrimination-and-Accessibility-Hmong
Megan Sims, Pending 2024 Review, Yomayra Gomez
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Notice-of-Nondiscrimination-and-Accessibility-Spanish
Megan Sims, Pending 2024 Review, Yomayra Gomez
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NoticePrivacyPractice_2021
Ka Vang, Pending 2024 Review, Rebecca Seligman
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NoticePrivacyPractice_2021_HM
Ka Vang, Pending 2024 Review, Rebecca Seligman
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NoticePrivacyPractice_2021_SP
Ka Vang, Pending 2024 Review, Rebecca Seligman
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PCL_combined
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PCR_AUTH_REF
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PCS_NEMT_Form
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PD_IHSS
Melissa Kelly-Ortega, Pending 2024 Review, Rachaelle Schultze
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PD_MC_Merced
Melissa Kelly-Ortega, Pending 2024 Review, Rachaelle Schultze
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PD_MC_SB
Melissa Kelly-Ortega, Pending 2024 Review, Rachaelle Schultze
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CCAH Monterey and Santa Cruz County Provider Directory

PD_MC_SC_MTRY
Melissa Kelly-Ortega, Pending 2024 Review, Rachaelle Schultze
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PDSA Guide
Naomi Kawabata, Pending 2024 Review
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PDSA Project Tracker
Naomi Kawabata, Pending 2024 Review
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Personal_Representative_Request_Form_EN
Megan Sims, Pending 2024 Review, Yomayra Gomez
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PM-330_Eng-SP
Pending 2024 Review, Tammy Brass
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POLST_2017_wCover
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Portal_Quick_Reference_Linked_Members
Minerva Galvan, Pending 2024 Review
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Prescription_Prior_Authorization_Request_Form
Navneet Sachdeva, Pending 2024 Review, Yasuno Sato
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Printing to PDF
Pending 2024 Review, Sky Collins
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Prior_Authorization_Criteria
Hayley Baudet, Pending 2024 Review
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PROV_2021-website-launch_F_ENG
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PROV_ACE_Resource_Guide
Jessica Hampton, Pending 2024 Review
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PROV_CBI_2022_Webinar_FAQ
Britta Vigurs, Kristen Rohlf, Pending 2024 Review
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PROV_Change-in-Ownership_F_EN
Jessie Dybdahl, Pending 2024 Review
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PROV_CMS-Roll-Up-Billing
Pending 2024 Review, Sharlene Gianopoulos
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PROV_DME-Credentialing-Application_F_ENG
Jessie Dybdahl, Pending 2024 Review
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PROV_doula-credentialing-application_fillable_final
Crystral Kerr, Jessie Dybdahl, Pending 2024 Review
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PROV_ECM-CS-Invoice-FAQ
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PROV_Invoice-Roll-Up-Billing
Pending 2024 Review, Sharlene Gianopoulos
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PROV_Maximizing-Routine-IZ-during-COVID_ENG
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PROV_Member_Satisfaction_Toolkit_2021
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PROV_Non-Physician-Medical-Practitioner_F_ENG
Jessie Dybdahl, Pending 2024 Review
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PROV_Organizational-Provider-Credentialing-Application_F_ENG
Jessie Dybdahl, Pending 2024 Review
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PROV_Outpatient-Laboratory-Provider-Credentialing-Application_F_ENG
Jessie Dybdahl, Pending 2024 Review
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PROV_PassThrough-SupplementalPayments_FAQ_ENG
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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PROV_Pediatric-Screening-Tool-2023
Georgia Gordon, Pending 2024 Review
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PROV_Pediatric-Vaccines-Tool-2023
Georgia Gordon, Pending 2024 Review
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PROV_Physician-Credentialing-Application_F_ENG
Jessie Dybdahl, Pending 2024 Review
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PROV_Transportation-Credentialing-Application_F_ENG
Jessie Dybdahl, Pending 2024 Review
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Provider Portal Reports Webinar FAQ Guide
Minerva Galvan, Pending 2024 Review
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Provider_FAQ_for_BHT_Services
Jennifer Mockus, Julie Norton, Pending 2024 Review
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Provider_Inquiry_Form
Jeanette Alvarez, Pending 2024 Review
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Provider_Manual
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Provider_Manual_072022
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Provider_Recruitment_Eligible_Expenses
Jessica Finney, Pending 2024 Review
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Provider-incentive-flyer
Jim Lyons, Pending 2024 Review
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PROVIDER-New-Doula-Provider-Training-ENG-Condensed
Melissa Kelly-Ortega, Pending 2024 Review
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PROVIDER-New-ECM-Community-Supports-Provider-Training-ENG
Jennifer Mockus, Jessica Hampton, Pending 2024 Review
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Provider-Portal-User-Guide
Minerva Galvan, Pending 2024 Review
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RA_Explanation_Codes
Pending 2024 Review, Sharlene Gianopoulos
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RA_Guide
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Request-to-Opt-in-Form
Jessie Dybdahl, Jim Lyons, Pending 2024 Review
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Run Chart Guide
Naomi Kawabata, Pending 2024 Review
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SH_OrderForm
Desirre Herrera, Pending 2024 Review
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Spanish_POLST_2016
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Standing Order Doula
Melissa Kelly-Ortega, Pending 2024 Review
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TeleMed2U_flyer_EN
Angelica Baltazar, Jim Lyons, Pending 2024 Review
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Treatment_Authorization_Request
Pending 2024 Review, Tammy Brass
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TSWVCUAB DAIM NTAWV TSO CAI SIV LOSSIS QHIA TAWM COV NTAUB NTAWV KUAJ MOB NKEEG TXWV TSIS PUB QHIA TAWM YOG TSIS TAU KEV TSO CAI
Megan Sims, Pending 2024 Review, Yomayra Gomez
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