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Site reviews ensure that all primary care provider (PCP) sites meet the prescribed standards of the California Department of Health Care Services (DHCS)/Medi-Cal Managed Care Division (MMCD).
- An Initial Facility Site Review (FSR) is part of the credentialing process.
- New PCP sites must pass their Initial FSR before receiving Alliance member assignments.
- The Alliance conducts an initial Medical Record Review (MMR) approximately 3-6 months following the ﬁrst member assignment.
- The Alliance conducts a periodic full scope FSR and MRR every 36 months thereafter.
- Every 18 months, the Alliance performs an interim monitoring review via and attestation form or site visit.
- Ib Physical Accessibility Review (PAR) evaluates the level of physical accessibility of the health care site. The PAR is conducted as part of every PCP FSR. It is also required as an independent review process for specialists and allied providers serving a high volume of Medi-Cal members who are part of the Seniors and Persons with Disabilities (SPD) population.
DHCS-Certiﬁed Nurse Reviewers conduct the FSR and MMR and score them with standardized DHCS guidelines and audit tools.
The purpose of the reviews is to ensure that the clinic:
- Provides appropriate primary health care services.
- Has consistent processes that support continuity and coordination of care.
- Maintains patient safety standards and practices.
- Operates in compliance with applicable local, state, and federal laws and regulations.
All plan training video:
Contact Provider Services
Contact the Site Review Team
- Tus Xov Tooj: 831-430-2622
- Tus Xov Tooj Xa Ntawv (Fax): 831-430-5890; “Attention: Facility Site Review Team”
- Xa Email: email@example.com