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Pending Department Review

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

Enhanced Care Management (ECM) and Community Supports

Provider Event Submission

FSR and MRR Update Attestation

Provider Events Calendar

Provider Compliance Concern Report

Provider News Archives

Nyob ib kauj ruam ua ntej kom tsis txhob kis tau tus kab mob COVID-19

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

Zej Zog Cov Ntaub Ntawv Tshaj Tawm

2021 PNA Report (Tri-county)

Daim ntawv ceeb toom cuam tshuam

Member Grievance Form – IHSS

Member Grievance Form – Medi-Cal

Community Support Services Member Referral Form

Daim Ntawv Foos Xa Tswvcuab Mus Kho Mob

Enhanced Care Management Provider Referral Form

Community Supports Provider Referral Form

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

Screening for Depression and Follow-Up Plan Tip Sheet

Cov Tswv Cuab lub online account

New Provider ECM/Community Supports Training Sign Off Form

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

Procedure Code Lookup Tool

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

Lub vev xaib cov lus taw qhia

Medi-Cal Rx

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

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

Pharmacy Forms

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

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

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

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

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

COVID-19 Cov Lus Qhia

Patient Complaint/Grievance Tracking Log

Member Appointment No-Show Notification

Locum Tenens Notification Form

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)

CPT/Procedure Code Inquiry Form

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

HEDIS FAQ Guide

Chronic and Persistent Conditions Health Measures

Child and Adolescent Health Measures

Behavioral Health Measures

Women’s Health Measures

Procedure Reimbursement Rate Request

HEDIS Resources

Kev Sib tham Hauv Vis Dis Aus (Video) lossis Hu Xov Tooj Nrog Kws Kho Mob (Telehealth)

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

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

COVID-19 Vaccine Administration for Providers

PCP Blood Lead Testing Flyer

Initial Health Assessment Billing Code List

Kev Pab Cuam Tswj Kev Tu Xyuas

Physical Accessibility Review

Medical Record Review

Facility Site Review

Unhealthy Alcohol Screening and Behavioral Counseling

Staying Healthy Assessment

Initial Health Assessment

Cov Kev Them Nyiaj Raws Tus Nqi

Cov Kev Tshuaj Xyuas Cov Chaw Kuaj Mob

Cov Kev Txhawb Zog Rau Tus Tswvcuab

Immunization Resources

HEDIS

Health Assessments

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

Kev Xa Mus thiab Kev Tso Cai

Provider Information Change Form

Kev Txais Kev Kho Mob Kom Raws Sijhawm

Kev Pab Kho Cwj Pwm

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

Credentialing Applications and Policies

Kev Thov Rau Daim Ntawv Thov Nkag

Yuav Koom Nrog Li Cas

Vim Li Cas Ho Koom Nrog

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

Cov Kev Pab Kho Mob

Koom Nyob Hauv Peb Pab Pawg Koom Tes

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

Cov Ntsiab Lus Txhais

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 Directory

Pharmacy Services

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

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

Alliance Care IHSS Phau Ntawv Rau Tus Tswvcuab

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

Over-the-phone Interpreting Language List

Cov Kev Pab Cuam Kab Lis Kev Cai thiab Txhais Lus

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

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

Daim Qhia Txog Cov Kev Kho Mob Uas Pab Them Rau

Phau Ntawv Rau Tus Tswvcuab

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

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

Cov Xov Xwm Qhia Rau Kws Kho Mob

Cov Kev Thov

Phau Ntawv Rau Tus Kws Kho Mob

Phau Ntawv Teev Npe Cov Kws Kho Mob

Immunizations: Adolescents Tip Sheet

Care-Based Incentive (CBI) Summary

Care-Based Incentive Resources

Care-Based Incentive

Kev Pab Saib Xyuas Kho Mob Kom Zoo

Kev Pab Tswj Kho Mob

Cov Kev Pab Rau Neeg Zej Zog

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

Koj Li Kev Noj Qab Haus Huv Tseem Ceeb (Your Health Matters)

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

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

Nyob Nrog Txoj Kev Noj Qab Nyob Zoo

Kev Tswj Tus Kab Mob

Substance Use/Tobacco Events

Domestic Violence Events

Social Support Services Events

Alternative Treatments Events

Pain Management Events

Nutrition and Fitness Events

Qhov Kev Npaj Kho Mob Rau Cov Menyuam Yaus Pab Neeg Tawm Tswvyim Los Pab Cov Tsev Neeg (Whole Child Model Family Advisory Committee; WCMFAC)

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

Webinars and Training

Cov Kev Pab

Capital Program

Partners for Healthy Food Access Program

Provider Recruitment Program

Using the Online Grant Portal

How to Apply

Funding Opportunities

Medi-Cal Capacity Grant Program

Rau Cov Zej Zog

Cov Nyiaj Pab Rau Zej Zog

Cov Chaw Haujlwm Muab Kev Kho Mob Ceev hauv Lub Cheeb Nroog Merced

Cov Chaw Haujlwm Muab Kev Kho Mob Ceev hauv Lub Nroog Santa Cruz

Daim Ntawv Thov Nkag Qhov Kev Npaj Kho Mob Rau Cov Menyuam Yaus Pab Neeg Tawm Tswvyim Los Pab Cov Tsev Neeg

Txoj Cai Rau Kev Tsis Cais Kev Npaj Kho Mob

Daim Ntawv Ua Hais Kev Tsis Txaus Siab

Kev Siv Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv

Rau Cov Kws Pab Kho Mob

Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv

Kev Hloov Tus Thawj Kws Kho Mob

Lus Qhia Txog Kev Fajseeb Kho Mob

Kev Hloov Kho Dua Tshiab Lwm Qhov Kev Fajseeb Kho Mob

Cov Chaw Haujlwm Muab Kev Kho Mob Ceev hauv Lub Cheeb Nroog Monterey

Cov Kev Pab Cuam Rau Kev Noj Qab Nyob Zoo

Lwm Cov Kev Pab Cuam

Behavioral/Mental Health Events

Kev Nyob Noj Qab Haus Huv thiab Noj Qab Nyob Zoo

Santa Cruz County Health and Wellness Events

Cov Lus Thov Txwv Tsis Pub Lwm Tus Paub

Kev Nthuav Tawm Ntaub Ntawv

Kev Thov Rau Tus Neeg Sawv Cev Rau Koj

Daim Ntawv Foos Thov Them Nyiaj Rov Qab Rau Tus Tswvcuab

Kev Hloov Kho Dua Tshiab Koj Tus Kheej Cov Ntaub Ntawv

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

Koj tau no koob tshuaj ua npaws rau leej twg lawm?

Cov Xov Xwm Qhia Rau Tswvcuab

Alliance Cov Kev Pab Cuam Txhais Lus

Koom Nrog Pab Neeg Tawm Tswv Yim

Ua ib Daim Ntawv Hais Kev Tsis Txaus Siab

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

Cov Kev Pab Cuam Tswvcuab

Kev Pab Cuam Saum Oos Lais (Online)

Cov Lus Uas Nquag Nug

Hais Txog Koj Txoj Kev Npaj Kho Mob

Nrhiav ib Tus Kws Kho Mob