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Pending 2022 Annual Review

2011 GNA Report (Merced County)

2016 GNA Report (Merced County)

2016 GNA Report (Santa Cruz and Monterey Counties)

2020 PNA report (tri-county)

Xyoo 2021 Txoj Kev Npaj Thiab Cov Hom Phiaj Los Pab Cov Tswvcuab (Bridge Plan)

2021 PNA Report (Tri-county)

90-Day Referral Completion – Exploratory Measure Tip Sheet

A to Z Glossary of Spanish & Hmong Terms

Hais Txog Alliance

Hais Txog Koj Txoj Kev Npaj Kho Mob

Nkag Mus Saib Tau Koj Cov Ntaub Ntawv Hais Txog Kev Noj Qab Haus Huv

Adult Behavioral Health Screening Form

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

Alliance Cov Cai Rau Lwm Txoj Hauv Kev Mus Txais Tau Kev Pab Kho Mob (Alliance Alternative Access Standards)

Alliance Care IHSS Daim Ntawv Qhia Txog Cov Kev Kho Mob Uas Pab Them Rau

Alliance Care IHSS Phau Ntawv Rau Tus Tswvcuab

Alliance Care IHSS Daim Ntawv Qhia Txog Cov Kev Pab Kho Mob Uas Txais Tau thiab Cov Kev Fajseeb Kho Mob

Alliance Cov Kev Pab Saib Xyuas Mob Nkeej Rau Tom Tsev (IHSS)

Alliance Holidays

Alliance Cov Kev Pab Cuam Txhais Lus

Allied Health Professional Credentialing Application

Alternative Treatments Events

Kuv Puas Tsim Nyog Tau Txais?

Kuv Puas Tsim Nyog Tau Txais?

Ambulatory Care Sensitive Admissions Tip Sheet

Antidepressant Medication Management Tip Sheet

Application of Fluoride Varnish Tip Sheet

Kev Thov Rau Daim Ntawv Thov Nkag

Cov Kev Pom Zoo rau Kev Kho Mob

Asthma Education Benefit Description

Asthma Education is Available for Your Alliance Patients

Asthma Medication Ratio Tip Sheet

Asthma Self-Management Education Checklist

Authorization Status Request

Beacon Care Management Referral Form

Beacon Diagnostic Evaluation Form (Medi-Cal)

Beacon Health Options Medi-Cal Provider FAQs

Beacon Health Options Primary Care Provider (PCP) Referral Form

Beacon Health Options Referral Card

Beacon Health Options Screening Guidelines for Autism

Beacon Primary Care Provider (PCP) Referral Form with Spanish

Kev Pab Kho Cwj Pwm

Kev Pab Kho Cwj Pwm

Behavioral Health Measures

Behavioral/Mental Health Events

Cov Kev Pab Kho Mob Uas Txais Tau

Cov Kev Pab Kho Mob Uas Txais Tau

Best Practices for Reducing Patient No-Shows Tip Sheet

Blood Lead Testing Flyer

Breast Cancer Screening Tip Sheet

Breastfeeding and Lactation Education Checklist

Kev Pab Txhawb Me Nyuam Noj Mis thiab Cov Nyiaj Pab Taub Mis

Breastfeeding Support and Breast Pump Benefit Clinical Health Education Benefit

California Advance Health Care Directive Form

California Kev Pab Kho Mob Rau Menyuam Yaus (California Children’s Services; CCS, raws li sau hauv lus Askiv)

California Kev Pab Kho Mob Rau Menyuam Yaus (CCS) Qhov Kev Npaj Kho Mob Rau Cov Menyaum Yaus

California Management Guidelines: Childhood Lead Poisoning

California Participating Practitioner Application

Capital Program

Kev Pab Cuam Tswj Kev Tu Xyuas

Care-Based Incentive

Care-Based Incentive (CBI) Summary

Care-Based Incentive Resources

Cov Haujlwm Qhib

Case Management Referral Form

CBI Technical Specifications

Central California Alliance for Health

Certification Regarding Debarment Suspension, Ineligibility and Voluntary Exclusion

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

Cervical Cancer Screening Tip Sheet

Kev Hloov Tus Thawj Kws Kho Mob

Hu, Thiab Teem Sijhawm Kuaj Mob.

Child and Adolescent Health Measures

Child and Adolescent Well-Care Visits Tip Sheet

Child and Adolescents BMI Assessment Tip Sheet

Child Behavioral Health Screening Form

Chlamydia Screening in Women – Exploratory Measure Tip Sheet

Chronic and Persistent Conditions Health Measures

Cov Kev Thov

Clinical Health Education Benefits Provider Application

Cov Kev Pab Kho Mob

Community Based Adult Services (CBAS) Inquiry Form

Cov Nyiaj Pab Rau Zej Zog

Zej Zog Cov Ntaub Ntawv Tshaj Tawm

Cov Kev Pab Rau Neeg Zej Zog

Community Support Services Member Referral Form

Community Supports Provider Referral Form

Cov Kev Pab Cuam Hauv Lub Zej Zog Rau Cov Neeg Laus (Community-Based Adult Services; CBAS, raws li sau hauv lus Askiv)

Complex Case Management and Care Coordination

Daim Foos Thov Kom Xa Cov Ntawv Txwv Tsis Pub Lwm Tus Paub Rau Lwm Txoj Kev Sib Txuas Lus

Consent for Sterilization or Hysterectomy Sample Form

Hu Tuaj Rau Peb

Controlling High Blood Pressure – Exploratory Measure Tip Sheet

Corrected Claim Submission Form

COVID-19 Cov Lus Qhia

COVID-19 Vaccine Administration for Providers

Lus Qhia Txog Koob Txhaj Tshuaj Tiv Thaiv Kab Mob COVID-19 rau Cov Tswvcuab Medi-Cal

Lus Qhia Txog Koob Tshuaj Txhaj Tiv Thaiv Kab Mob Rau Medi-Cal Cov Tswvcuab Daim ntawv qhia

COVID-19 Vaccine Information Videos

COVID-19: Information for Providers

CPT/Procedure Code Inquiry Form

Credentialing Applications and Policies

Credit Balance Report

Cov Kev Pab Cuam Kab Lis Kev Cai thiab Txhais Lus

Kev Kho Hniav thiab Kev Kho Qhov Muag

Depression Tool Kit

Developer Application

Developer Questionnaire

Developer Resources

Developmental Screening in the First 3 Years Tip Sheet

DHCS Facility Site Review (FSR) Checklist

DHCS Medical Record Review (MRR) Checklist

DHCS Vaccine Recommendations During COVID-19

Diabetes Eye Exam Services Resource List – English

Diabetes Eye Exam Services Resource List – Hmong

Diabetes Eye Exam Services Resource List – Spanish

Diabetes Prevention Program (DPP) Benefit Description

Diabetes Self-Management Education Benefit Description

Diabetic HbA1c Poor Control >9% Tip Sheet

Disease Management Programs

Domestic Violence Events

Durable Medical Equipment Provider Application

EDI Claims Enrollment Form

EDI Claims Enrollment Form Instructions

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

Enhanced Care Management (ECM) and Community Supports

Daim Ntawv Foos Xa Tswvcuab Mus Kho Mob

Kev Txhim Khu Kev Pab Tswj Kev Tu Xyuas thiab Zej Zog Kev Pab Txhawb

Enhanced Care Management Provider Referral Form

Face-to-Face Interpreter Request Form

Facility Site Review

Daim Ntawv Qhia Txog Qhov Tsheeb

Kev Npaj Kom Muaj Menyuam

Ua ib Daim Ntawv Hais Kev Tsis Txaus Siab

Nrhiav ib Tus Kws Kho Mob

Rau Cov Zej Zog

Rau Cov Tswvcuab

Rau Cov Kws Pab Kho Mob

Cov Lus Uas Nquag Nug

FSR and MRR Update Attestation

FSR Critical Elements: Interim Monitoring Form

Funding Opportunities

Kev Txais Kev Kho Mob

Los Pib Tau

Cov Ntsiab Lus Txhais

Daim Ntawv Ua Hais Kev Tsis Txaus Siab

Kev Nyob Noj Qab Haus Huv thiab Noj Qab Nyob Zoo

Cov Nqi Zog Rau Kev Nyob Noj Qab Haus Huv thiab Noj Qab Nyob Zoo

Daim Ntawv Qhia Txog Cov Nqi Zog Rau Kev Nyob Noj Qab Haus Huv thiab Noj Qab Nyob Zoo

Health Assessments

Kev Pab Qhia Txog Kev Noj Qab Haus Huv thiab Kev Pab Tswj Kab Mob

Health Education Programs

Qhov Kev Npaj Kho Mob

Health Programs Referral Form

Health Resources

Healthy Breathing for Life Asthma Management Program

Cov Kev Pab Kom Neeg Zej Zog Muaj Kev Noj Qab Haus Huv

HEDIS

HEDIS Code Set

HEDIS FAQ Guide

HEDIS Resources

How to Apply

Yuav Koom Nrog Li Cas

Yuav Koom Nrog Li Cas

Yuav Koom Nrog Li Cas

Immunization Resources

Immunizations: Adolescents Tip Sheet

Immunizations: Adult – Exploratory Measure Tip Sheet

Immunizations: Children (Combo 10) Tip Sheet

Daim ntawv ceeb toom cuam tshuam

Infection Control: Spore Testing Job Aid

Kev Nthuav Tawm Ntaub Ntawv

Initial Health Assessment

Initial Health Assessment Billing Code List

Initial Health Assessment Tip Sheet

Cov lus qhia txog yuav ua li cas thiaj rub tawm tau ib daim ntawv foos 

Lus Qhia Txog Kev Fajseeb Kho Mob

International Board Certified Lactation Consultants and Breast Pump Vendor List

Interpreter Services Provider Quick Reference Guide

Interpreter Services Quality Assurance Form

Cov Lus Qhia Txog Qhov Kev Pab Cuam Medi-Cal Rx

job

Koom Nrog Pab Neeg Tawm Tswv Yim

Koom Nyob Hauv Peb Pab Pawg Koom Tes

Language Assistance Label Template

Lead Screening in Children – Exploratory Measure Tip Sheet

Cov Thawj Coj

Locum Tenens Notification Form

Long Term Care Treatment Authorization Request

Kev Pab Tswj Kho Mob

Kev Tswj Tus Kab Mob

Maternity Care: Postpartum Tip Sheet

Maternity Care: Prenatal Tip Sheet

Maximizing Routine Immunization During the COVID-19 Pandemic

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

Medi-Cal

Medi-Cal Capacity Grant Program

Daim Qhia Txog Cov Kev Kho Mob Uas Pab Them Rau

Phau Ntawv Rau Tus Tswvcuab

Medi-Cal Provider-Preventable Conditions Reporting Portal

Medi-Cal Rx

Medical Clearance for General Anesthesia or IV Sedation for Dental Procedures

Khoom Siv Kho Mob

Medical Nutrition Therapy Benefit Quick Reference Guide

Medical Record Review

Medication Management Agreement (MMA)

Member Appointment No-Show Notification

Member Grievance Form – IHSS

Member Grievance Form – Medi-Cal

Tus Tswvcuab Daim Npav ID

Cov Kev Txhawb Zog Rau Tus Tswvcuab

Cov Xov Xwm Qhia Rau Tswvcuab

Member Notice Letters

Cov Tswv Cuab lub online account

Daim Ntawv Foos Thov Them Nyiaj Rov Qab Rau Tus Tswvcuab

Cov Kev Pab Cuam Tswvcuab

Pab Neeg Tawm Tswvyim Los Pab Tswvcuab (Member Services Advisory Group; MSAG)

Daim Ntawv Thov Pab Pawg Pab Tswv Yim Rau Cov Kev Pab Cuam Tswv Cuab

Lub Zeem Muag, Lub Luag Haujlwm thiab Cov Kev Tseem Ceeb

New Non-PCP Training

New PCP Training

New Provider Attestation Form

New Provider ECM/Community Supports Training Sign Off Form

Txoj Kev Muab Kev Kawm Qhia Rau Cov Kws Pab Kho Mob Tshiab

Cov Xov Xwm

Non-Physician Medical Practitioner Application

Txoj Cai Rau Kev Tsis Cais Kev Npaj Kho Mob

Daim Ntawv Ceeb Toom Txog Kev Txwv Tsis Pub Lwm Tus Paub Txog

Tus Xov Tooj Nug Kev Pab Los Ntawm Ib Tus Kws Tu Neeg Mob

Tus Xov Tooj Nug Kev Pab Los Ntawm Ib Tus Kws Tu Neeg Mob

Nutrition and Fitness Events

Online Provider Directory Tutorial

Kev Pab Cuam Saum Oos Lais (Online)

Thov Rau Ib Daim Npav ID, Ib Phau Ntawv Rau Tus Tswvcuab thiab Ib Phau Ntawv Teev Npe Cov Kws Kho Mob

Organizational Provider Application

Other Health Coverage (OHC) Referral Form

Lwm Cov Kev Pab Cuam

Cov Kev Pab Cuam Uas Tsis Nyob Hauv Thaj Tsam

Outpatient Clinical Laboratory Provider Application

Over-the-phone Interpreting Language List

Pain Management and Substance Use Resources

Pain Management Events

Partners for Healthy Food Access Program

Pass Through/Supplemental Payments FAQ

Patient Access

Patient Complaint/Grievance Tracking Log

PCP Blood Lead Testing Flyer

PCP Decision Support Services

PCP MAT in the Provider Portal

Pharmacy Directory

Pharmacy Forms

Pharmacy Formulary

Pharmacy Services

Physical Accessibility Review

Physician Certification Statement of Medical Necessity for NEMT

Physician Orders for Life-Sustaining Treatment (POLST)

Plan All-Cause Readmissions Tip Sheet

Cov Nqi Uas Yuav Tau Them

Prescription Drug Prior Authorization or Step Therapy Exception Request Form

Cov Tshuaj Raws Daim Ntawv Xaj Yuav Tshuaj thiab Cov Kev Txais Tau Tshuaj

Preventable Emergency Care Visit Diagnosis Tip Sheet

Preventable Emergency Visits Tip Sheet

Prevention and Self-Management Programs

Thawj Qhov Kev Kho Mob

Prior Authorization Criteria

Prior Authorization Information Request for Injectable Drugs

Txoj Cai Txwv Tsis Pub Lwm Tus Paub

Cov Lus Thov Txwv Tsis Pub Lwm Tus Paub

Procedure Code Lookup Tool

Procedure Reimbursement Rate Request

Programmatic Measure Benchmarks & Performance Improvement

Promoting Cultural and Linguistic Competency

Provider Approval Checklist Diabetes Prevention & Self Management Education

Provider Change Request (PCR)

Provider Compliance Concern Report

Phau Ntawv Teev Npe Cov Kws Kho Mob

Phau Ntawv Teev Npe Cov Kws Kho Mob

Provider Event Submission

Provider Events Calendar

Provider Identified Overpayment Form

Provider Information Change Form

Provider Inquiry Form

Phau Ntawv Rau Tus Kws Kho Mob

Cov Xov Xwm Qhia Rau Kws Kho Mob

Provider News Archives

Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv

Provider Portal Account Request Form

Provider Portal Frequently Asked Questions

Provider Portal Quick Reference

Provider Portal User Guide

Provider Recruitment Program

Cov Rooj Sib Tham Qhib Rau Pej Xeem

Kev Pab Saib Xyuas Kho Mob Kom Zoo

Kev Xa Mus thiab Kev Tso Cai

Remittance Advice Explain Codes

Remittance Advice Guide

Request for Member Reassignment Form