Pending Department Review

Linguistic Competence Provider Incentive Attestation

Update your Medi-Cal

El Manejo Mejorado del Cuidado y los Apoyos Comunitarios 

Community Supports: Environmental Accessibility and Adaptability (EAA) Provider Referral Form

Community Supports: Meals Provider Referral Form

Apoyos Comunitarios

Manejo Mejorado del Cuidado (ECM)

Colorectal Cancer Screening – Exploratory Measure Tip Sheet

EDI Claims Enrollment Form Online

MCGP Publications

Herramienta de Transparencia de Precios de Alliance Care para los IHSS

Cambios a la Carga Pública

Request for Provider Information

Grievance Form In-Home Supportive Services (IHSS)

Formulario de Quejas/Apelacíon para el Programa Medi-Cal

Provider Portal Account Request Form – Step 2

Eventos Comunitarios

Pharmacy Forms

Locum Tenens Notification Form

Webinars Archive List

Dejar el Tabaco

Programa Wellness that Works

Peso Sano de Por Vida

Mamás Saludables, Bebés Sanos


Condiciones Crónicas



Consultas de Bienestar Infantil

Calendarios de Inmunizaciones y Vacunas

Salud y Bienestar

Provider News Posts

Our Test Page

2022 PNA Report (Tri-county)

Formulario De Solicitud De Comunicaciones Confidenciales

Manejo Mejorado del Cuidado (Enhanced Care Management; ECM por sus siglas en inglés) y Apoyos Comunitarios (Community Supports)

Provider Event Submission

FSR and MRR Update Attestation

Provider Events Calendar

Provider Compliance Concern Report

Provider News Archives

Manténgase un paso adelante del COVID-19

Instrucciones sobre cómo descargar un formulario

Publicaciones Comunitarias

2021 PNA Report (Tri-county)

Informes de Impacto a la Comunidad

Member Grievance Form – IHSS

Member Grievance Form – Medi-Cal

Formulario de Referencia para Miembros para los Servicios de Apoyos Comunitarios

Formulario de Referencia para Miembros para el Manejo Mejorado del Cuidado

Enhanced Care Management Provider Referral Form

Community Supports: Housing Provider Referral Form

Adverse Childhood Experiences (ACEs) Screening in Children and Adolescents Tip Sheet

Screening for Depression and Follow-Up Plan Tip Sheet

Cuenta en línea del Miembro

New Provider ECM/Community Supports Training Sign Off Form

El Manejo Mejorado del Cuidado y los Apoyos Comunitarios 

¡Destruye el COVID!

Procedure Code Lookup Tool

Presentando Medi-Cal Rx

Comentarios del sitio web

Medi-Cal Rx

Aviso de Prácticas de Privacidad

New Provider Attestation Form

Provider Approval Checklist Diabetes Prevention & Self Management Education

Asthma Education is Available for Your Alliance Patients

Prevention and Self-Management Programs

2011 GNA Report (Merced County)

2016 GNA Report (Merced County)

2016 GNA Report (Santa Cruz and Monterey Counties)

2020 PNA report (tri-county)

Diabetes Eye Exam Services Resource List – Hmong

Diabetes Eye Exam Services Resource List – Spanish

Diabetes Eye Exam Services Resource List – English

COVID-19 Vaccine Information Videos

COVID-19: Information for Providers

Online Provider Directory Tutorial

PCP MAT in the Provider Portal

Asthma Education Benefit Description

Beacon Care Management Referral Form

Child Behavioral Health Screening Form

Adult Behavioral Health Screening Form

Beacon Diagnostic Evaluation Form (Medi-Cal)

Beacon Primary Care Provider (PCP) Referral Form with Spanish

PCP Decision Support Services

Beacon Health Options Primary Care Provider (PCP) Referral Form

Maximizing Routine Immunization During the COVID-19 Pandemic

New Non-PCP Training

New PCP Training

Beacon Health Options Referral Card

Beacon Health Options Screening Guidelines for Autism

Beacon Health Options Medi-Cal Provider FAQs

Apoyo para la Lactancia Materna y Beneficio de Extractor de Leche

Maximizing Your Value-Based Payments using CPT Category II Coding Tip Sheet

Health Resources

Seniors and Disabilities

Pain Management and Substance Use Resources

Complex Case Management and Care Coordination

Diabetes Prevention Program (DPP) Benefit Description

Tobacco Cessation Benefit Description

International Board Certified Lactation Consultants and Breast Pump Vendor List

Breastfeeding Support and Breast Pump Benefit Clinical Health Education Benefit

Healthy Breathing for Life Asthma Management Program

Clinical Health Education Benefits Provider Application

Breastfeeding and Lactation Education Checklist

Asthma Self-Management Education Checklist

Diabetes Self-Management Education Benefit Description

Health Programs Referral Form

Disease Management Programs

Health Education Programs

Member Notice Letters

Request for Member Reassignment Form

Provider Inquiry Form

Transportation Provider Application

Outpatient Clinical Laboratory Provider Application

Durable Medical Equipment Provider Application

Organizational Provider Application

Allied Health Professional Credentialing Application

Non-Physician Medical Practitioner Application

California Participating Practitioner Application

Información Sobre el COVID-19

Patient Complaint/Grievance Tracking Log

Member Appointment No-Show Notification

Certification Regarding Lobbying – Exhibit D(F) Att 1 and 2

Certification Regarding Debarment Suspension, Ineligibility and Voluntary Exclusion

Transportation Services Request Form

Physician Certification Statement of Medical Necessity for NEMT

Physician Orders for Life-Sustaining Treatment (POLST)

Medication Management Agreement (MMA)

Medical Clearance for General Anesthesia or IV Sedation for Dental Procedures

Medi-Cal Provider-Preventable Conditions Reporting Portal

Consent for Sterilization or Hysterectomy Sample Form

Community Based Adult Services (CBAS) Inquiry Form

Long Term Care Treatment Authorization Request

Authorization Status Request

Provider Change Request (PCR)

Case Management Referral Form

California Advance Health Care Directive Form

Other Health Coverage (OHC) Referral Form

Provider Identified Overpayment Form

Credit Balance Report

Corrected Claim Submission Form

Pass Through/Supplemental Payments FAQ

Remittance Advice Explain Codes

Remittance Advice Guide

EDI Companion Guide – 270/271 Information

EDI Companion Guide – 276/277 Information

EDI Companion Guide – 837/835 Trading Partner Information

EDI Companion Guide – Transaction Instruction

EDI Claims Enrollment Form Instructions

EDI Claims Enrollment Form

HEDIS Code Set


Chronic and Persistent Conditions Health Measures

Child and Adolescent Health Measures

Behavioral Health Measures

Women’s Health Measures

Procedure Reimbursement Rate Request

HEDIS Resources


DHCS Medical Record Review (MRR) Checklist

Infection Control: Spore Testing Job Aid

DHCS Facility Site Review (FSR) Checklist

FSR Critical Elements: Interim Monitoring Form

DHCS Vaccine Recommendations During COVID-19

COVID-19 Vaccine Administration for Providers

PCP Blood Lead Testing Flyer

Initial Health Assessment Billing Code List

Manejo de Cuidado

Physical Accessibility Review Survey

Medical Record Review

Facility Site Review

Unhealthy Alcohol Screening and Behavioral Counseling

Staying Healthy Assessment

Initial Health Assessment

Incentivos Basados en el Valor

Incentivos para los Miembros

Immunization Resources


Educación de Salud y Manejo de Enfermedades

Provider Information Change Form

Orientación para Nuevos Proveedores

Provider Credentialing Applications and Policies

Provider Application Request

Cómo inscribirse

Por Qué Unirse

Recursos Clínicos

Unirse a Nuestra Red

Glosario de Términos

Medical Nutrition Therapy Benefit Quick Reference Guide

Treatment Authorization Request (TAR)

Prior Authorization Information Request for Injectable Drugs

Synagis Statement of Medical Necessity

Provider Portal Account Request Form

Prior Authorization Criteria

Prescription Drug Prior Authorization or Step Therapy Exception Request Form

Pharmacy Formulary

Pharmacy Services

Alliance Care IHSS Resumen de beneficios y cobertura

Alliance Care IHSS cuadro de beneficios

Manual para Miembros de IHSS de Alliance Care

Información sobre las vacunas contra el COVID-19 para miembros de Medi-Cal

Promoting Cultural and Linguistic Competency

A to Z Glossary of Spanish & Hmong Terms

Interpreter Services Quality Assurance Form

Language Assistance Label Template

Tips For Working With Interpreters

Interpreter Services Provider Quick Reference Guide

Face-to-Face Interpreter Request Form

Servicios Culturales y Lingüísticos

Aplicación de Grupo Asesor de Servicios a los Miembros

Blood Lead Testing Flyer

California Management Guidelines: Childhood Lead Poisoning

Standard of Care Guidelines: Childhood Lead Poisoning

Depression Tool Kit

USPSTF Recommendations for Primary Care Practice

Preventable Emergency Care Visit Diagnosis Tip Sheet

Cuadro de beneficios cubiertos

Manual para Miembros

Estándares de accesos alternativos de la Alianza

Best Practices for Reducing Patient No-Shows Tip Sheet

Ambulatory Care Sensitive Admissions Tip Sheet

Well-Child Visits in the First 15 Months of Life Tip Sheet

Unhealthy Alcohol Use in Adolescents and Adults Tip Sheet

Tuberculosis (TB) Risk Assessment – Exploratory Measure Tip Sheet

Preventable Emergency Visits Tip Sheet

Maternity Care: Prenatal Tip Sheet

Maternity Care: Postpartum Tip Sheet

Plan All-Cause Readmissions Tip Sheet

Lead Screening in Children – Exploratory Measure Tip Sheet

Initial Health Assessment Tip Sheet

Diabetic HbA1c Poor Control >9% Tip Sheet

Developmental Screening in the First 3 Years Tip Sheet

Controlling High Blood Pressure – Exploratory Measure Tip Sheet

Immunizations: Children (Combo 10) Tip Sheet

Chlamydia Screening in Women – Exploratory Measure Tip Sheet

Child and Adolescent Well-Care Visits Tip Sheet

Cervical Cancer Screening Tip Sheet

Child and Adolescents BMI Assessment Tip Sheet

Breast Cancer Screening Tip Sheet

Application of Fluoride Varnish Tip Sheet

Asthma Medication Ratio Tip Sheet

Antidepressant Medication Management Tip Sheet

Immunizations: Adult – Exploratory Measure Tip Sheet

Programmatic Measure Benchmarks & Performance Improvement

Provider Portal User Guide

Provider Portal Quick Reference

Provider Portal Frequently Asked Questions

What’s New for the Care-Based Incentive Program

CBI Technical Specifications

90-Day Referral Completion – Exploratory Measure Tip Sheet

Noticias Sobre los Proveedores

Manual del Proveedor

Directorio de Proveedores

Immunizations: Adolescents Tip Sheet

Care-Based Incentive (CBI) Summary

Care-Based Incentive Resources

Care-Based Incentive

Calidad del Cuidado

Manejo de Cuidado

Recursos de la Comunidad

Comunidades Saludables

Recompensas de Salud y Bienestar

Mantenerse Sanos

Control de Enfermedades

Comité Consultivo de Familias del Modelo del Niño en su Totalidad (WCMFAC)

Webinars and Training

Provider Resources

Capital Program

Partners for Healthy Food Access Program

Provider Recruitment Program

Using the Online Grant Portal

How to Apply

Funding Opportunities

Para las Comunidades

Subsidios Comunitarios

Oficinas de Acceso para Visitas Urgentes en el Condado de Merced

Oficinas de Acceso para Visitas Urgentes en el Condado de Santa Cruz

Formulario de solicitud del Comité Consultivo de Familias del Modelo del Niño en su Totalidad (WCMFAC)

Política de No Discriminación

Formulario de Quejas/Apelacíon

Usar el Portal del Proveedor

Para Proveedores

Portal del Proveedor

Elija Doctor de Cuidado Primario

Información del Seguro

Oficinas de Acceso para Visitas Urgentes en el Condado de Monterey

Recursos de Bienestar

Otros Servicios

Solicitud de privacidad

Divulgación de Información

Solicitud de un representante personal

Formulario de Reclamo de Reembolso para Miembros

Actualizar Información de Contacto

Pedir Tarjeta de Identificación, Manual para Miembros y Directorio de Proveedores

No es demasiado tarde para vacunarse contra la gripe.

Boletín para los Miembros

Servicios de Asistencia con el Idioma de la Alianza

Servicios a los Miembros

Autoservicio en línea