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Pending Department Review

Kev Kuaj thiab Kho Tus Kab Mob COVID-19

Cov Xov Xwm Txog Tus Kab Mob COVID-19

Cov Xov Xwm Txog Cov Koob Tshuaj Tiv Thaiv Tus Kab Mob COVID-19

Carelon Primary Care Provider (PCP) Referral Form

Community Supports (CS) Provider Information

Enhanced Care Management (ECM) Provider Information

Enhanced Care Management (ECM) and Community Supports Provider Referrals

Enhanced Care Management and Community Supports for Members

Enhanced Care Management (ECM) and Community Supports Provider Information

Grants at Work

Enhanced Care Management (ECM) and Community Supports Trainings

Doula Provider Application

Cov Kev Pab Uas Txais Tau ntawm Kev Pab Cuam Txog Kev Yug Menyuam

Cov Kev Pab Txhawb Hauv Zej Zog: Cov Kev Pab Cuam Tu Neeg Thiab Tu Tsev thiab Kev Pab Cuam Rau Kev So Ib Vuag rau Cov Neeg Saib Xyuas txog ntawm Kev Xa Mus Rau Kws Kho Mob Pab Saib Xyuas

Daim Foos Hais Txog Kev Xa Mus Rau Kws Kho Mob Rau Cov Hluas Ntawm Pab Pawg Kev Txhim Khu Kev Pab Tswj Kev Tu Xyuas (20 xyoos thiab yau dua)

Community Supports: Personal Care and Home Maker Services and Respite Services for Caregivers Provider Referral

Youth Enhanced Care Management Provider Referral Form (age 20 and under)

Cov Kev Pab Kho Mob Uas Txais Tau Ntawm Tus Neeg Tuav Ntaub Ntawv rau Kev Noj Qab Haus Huv Hauv Zej Zog

Provider Network Interest Form

All Plan Letters

Parent Education and Support Program

Community Health Champions

Equity Learning for Health Professionals Program

Linguistic Competence Provider Incentive

Workforce Recruitment Programs

MA Recruitment Program

Provider Information Change Form

Healthcare Technology Program

Home Visiting Program

Partners for Active Living Program

CHW Recruitment Program

Tswvcuab Cov Xov Xwm

Re-Credentialing

Daim Foos Kev Xa Mus Rau Cov Tswvcuab Ntawm Pab Pawg Kws Tswj Kev Tu Xyuas Uas Muaj Kev Txhim Kho Rau Cov Neeg Laus (21 xyoos thiab tshaj ntawd)

Zej Zog Kev Pab Txhawb: Daim Ntawv Foos Xa Mus Txais Zaub Mov Noj Rau Tswvcuab

Zej Zog Kev Pab Txhawb: Daim Ntawv Foos Xa Mus Txais Kev Pab Vaj Tsev Nyob Rau Tswvcuab

Zej Zog Kev Pab Txhawb: Daim Ntawv Foos Xa Mus Xyuas Seb Puas Muaj Feem thiab Nyob Tau Tom Tsev (Environmental Accessibility and Adaptability; EAA, raws li sau hauv lus Askiv) Rau Tswvcuab

Txoj Kev Pab Cuam Txiaj Ntsig Pab Rau Kev Noj Qab Haus Huv

Kev Pib Noj Qab Haus Huv

Medi-Cal Renewal

Linguistic Competence Provider Incentive Attestation

Qhia dua tshiab txog koj qhov Medi-Cal

Kev Saib Xyuas Kev Kho Mob Uas Muaj Kev Txhim Kho Lawm thiab Kev Txhawb Nqa Zej Zog 

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

Community Supports: Meals Provider Referral Form

Cov Zej Zog Kev Pab Txhawb

Kev Txhim Kho Kev Pab Tswj Kev Tu Xyuas (Enhanced Care Managment; ECM raws li sau hauv lus Askiv)

Colorectal Cancer Screening – Exploratory Measure Tip Sheet

EDI Claims Enrollment Form Online

Tus Nqi Pob Tshab Ntawm Alliance Kev Saib Xyuas IHSS

Cov Kev Hloov rau Qhov Kev Pab Cuam Rau Pej Xeem Uas Tau Npav Ntsuab Ntawm Tsoom Fwv (Public Charge)

Request for Provider Information

Grievance Form In-Home Supportive Services (IHSS)

Daim Ntawv Ua Hais Kev Tsis Txaus Siab Rau Medi-Cal

Provider Portal Account Request Form – Step 2

Cov Koom Txoos Hauv Zej Zog

Pharmacy Forms

Locum Tenens Notification Form

Webinars Archive List

Kev Mus Ntsib tus Kws Kho Mob

Qhov Kev Pab Cuam Wellness that Works

Txoj Kev Pab Cuam Cia Lub Cev Hnyav Kom Haum Yuav Pab Tau Muaj Kev Noj Qab Nyob Zoo Mus Tag Tiam

Cov Leej Niam, Cov Menyuam Mosliab Muaj Kev Noj Qab Haus Huv

Kev Pub Niam Mis

Cov Kev Mob Mus Ntev

Kev Mob Ntshav Qab Zib/Kev Pib Mob Ntshav Qab Zib

Kev Mob Hawb Pob

Cov kev tuaj kuaj kuj

Cov Sijhawm Mus Txhaj Tiv Thaiv Kab Mob thiab Cov Koob Txhaj Tshuaj Tiv Thaiv Kab Mob

Kev Nyob Noj Qab Haus Huv thiab Noj Qab Nyob Zoo

Provider News Posts

Our Test Page

2022 PNA Report (Tri-county)

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

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)

Cov Ntaub Ntawv Qhia Tias Tau Pab Zej Zog Npaum Li Cas (Community Impact Reports)

Member Grievance Form – IHSS

Member Grievance Form – Medi-Cal

Adult Enhanced Care Management Provider Referral Form (age 21 and over)

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

Cov Tswv Cuab lub online account

New Provider ECM/Community Supports Training Sign Off Form

Xaus nrog COVID!

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

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

Carelon Care Management Referral Form

Carelon Diagnostic Evaluation Form (Medi-Cal)

PCP Decision Support Services

Maximizing Routine Immunization During the COVID-19 Pandemic

New Non-PCP Training

New PCP Training

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

Ntaub ntawv rau kab mob 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

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

COVID-19 Vaccine Administration for Providers

PCP Blood Lead Testing Flyer

Initial Health Appointment Billing Code List

Kev Pab Cuam Tswj Kev Tu Xyuas

Physical Accessibility Review Survey

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 Txhawb Zog Rau Tus Tswvcuab

Immunization Resources

HEDIS

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

Provider Directory Information Attestation Form

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

Provider Credentialing Applications and Policies

Yuav Koom Tau Li Cas

Vim Li Cas Ho Koom Nrog

Cov Kev Pab Kho Mob

Koom Nyob Hauv Peb Pab Pawg Koom Tes

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 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 Kev Saib Xyuas 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

Tips For Working With Interpreters

Interpreter Services Provider Quick Reference Guide

Face-to-Face Interpreter Request Form

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

Medi-Cal Phau Ntawv Qhia Siv Rau Tswv Cuab

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

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

Neeg zej zog muaj kev noj qab haus huv

Nyob Nrog Txoj Kev Noj Qab Nyob Zoo

Kev Tswj Tus Kab Mob

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)

Webinars and Training

Provider Resources

Capital Program

Partners for Healthy Food Access Program

Provider Recruitment Program

How to Apply

Rau Cov 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