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)

2021 Bridge Plan

2021 PNA Report (Tri-county)

2022 PNA Report (Tri-county)

90-Day Referral Completion – Exploratory Measure Tip Sheet

A to Z Glossary of Spanish & Hmong Terms

About the Alliance

Adult Behavioral Health Screening Form

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

Alliance Alternative Access Standards

Alliance Care IHSS Benefits Matrix

Alliance Care IHSS Member Handbook

Alliance Care IHSS Price Transparency Tool

Alliance Care IHSS Summary of Benefits and Coverage

Alliance Care In-Home Supportive Services (IHSS)

Alliance Holidays

Alliance Language Assistance Services

Allied Health Professional Credentialing Application

Am I Eligible?

Am I Eligible?

Ambulatory Care Sensitive Admissions Tip Sheet

Antidepressant Medication Management Tip Sheet

Application of Fluoride Varnish Tip Sheet

Approvals for Care


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

Behavioral Health Measures



Best Practices for Reducing Patient No-Shows Tip Sheet

Blood Lead Testing Flyer

Breast Cancer Screening Tip Sheet


Breastfeeding and Lactation Education Checklist

Breastfeeding Support and Breast Pump Benefit

Breastfeeding Support and Breast Pump Benefit Clinical Health Education Benefit

California Advance Health Care Directive Form

California Management Guidelines: Childhood Lead Poisoning

California Participating Practitioner Application

Capital Program

Care Management

Care-Based Incentive

Care-Based Incentive (CBI) Summary

Care-Based Incentive Resources


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

Changes to Public Charge

Check In, Check Up.

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

Choose Primary Doctor

Chronic and Persistent Conditions Health Measures

Chronic Conditions

Clinical Health Education Benefits Provider Application

Clinical Resources

Colorectal Cancer Screening – Exploratory Measure Tip Sheet

Community Based Adult Services (CBAS) Inquiry Form

Community Events

Community Grants

Community Impact Reports

Community Publications

Community Resources

Community Support Services Member Referral Form

Community Supports

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

Community Supports: Housing Provider Referral Form

Community Supports: Meals Provider Referral Form

Complex Case Management and Care Coordination

Confidential Communications Request Form

Consent for Sterilization or Hysterectomy Sample Form

Contact Us

Controlling High Blood Pressure – Exploratory Measure Tip Sheet

Corrected Claim Submission Form

COVID-19 Information

COVID-19 Vaccine Administration for Providers

COVID-19 Vaccine Information for Medi-Cal Members

COVID-19 Vaccine Information for Medi-Cal Members Flyer

COVID-19 Vaccine Information Videos

COVID-19: Information for Providers

CPT/Procedure Code Inquiry Form

Credit Balance Report

Crush COVID!

Cultural and Linguistic Services

Dental and Vision

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

Durable Medical Equipment Provider Application

EDI Claims Enrollment Form

EDI Claims Enrollment Form Instructions

EDI Claims Enrollment Form Online

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)

Enhanced Care Management (ECM) and Community Supports

Enhanced Care Management (ECM) Member Referral Form

Enhanced Care Management and Community Supports

Enhanced Care Management Provider Referral Form

Face-to-Face Interpreter Request Form

Facility Site Review

Fact Sheet

Family Planning

For Communities

For Members

For Providers

FSR and MRR Update Attestation

FSR Critical Elements: Interim Monitoring Form

Funding Opportunities

Get Care

Glossary of Terms

Grievance Form

Grievance Form In-Home Supportive Services (IHSS)

Grievance Form Medi-Cal

Health and Wellness

Health and Wellness Rewards

Health Education and Disease Management

Health Education Programs

Health Plans

Health Programs Referral Form

Health Resources

Healthy Breathing for Life Asthma Management Program

Healthy Communities

Healthy Moms, Healthy Babies

Healthy Weight for Life


HEDIS Code Set


HEDIS Resources

How to Apply

How to Join

How to Join

How to Join

Immunization Resources

Immunization Schedules and Vaccines

Immunizations: Adolescents Tip Sheet

Immunizations: Adult – Exploratory Measure Tip Sheet

Immunizations: Children (Combo 10) Tip Sheet

Infection Control: Spore Testing Job Aid

Information Release

Initial Health Assessment

Initial Health Assessment Billing Code List

Initial Health Assessment Tip Sheet

Instructions on how to download a form

Insurance Information

International Board Certified Lactation Consultants and Breast Pump Vendor List

Interpreter Services Provider Quick Reference Guide

Interpreter Services Quality Assurance Form

Introducing Medi-Cal Rx

It’s not too late to get your flu vaccine.


Join Our Network

Language Assistance Label Template

Lead Screening in Children – Exploratory Measure Tip Sheet


Linguistic Competence Provider Incentive Attestation

Locum Tenens Notification Form

Long Term Care Treatment Authorization Request

Manage Care

Managing Disease

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

MCGP Publications


Medi-Cal Covered Benefits Matrix

Medi-Cal Member Handbook

Medi-Cal Provider-Preventable Conditions Reporting Portal

Medi-Cal Rx

Medical Clearance for General Anesthesia or IV Sedation for Dental Procedures

Medical Equipment

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

Member ID Card

Member Incentives

Member Newsletter

Member Notice Letters

Member Online Account

Member Reimbursement Claim Form

Member Services

Member Services Advisory Group Application

Mission, Vision and Values

New Non-PCP Training

New PCP Training

New Provider Attestation Form

New Provider ECM/Community Supports Training Sign Off Form

New Provider Orientation


Non-Physician Medical Practitioner Application

Nondiscrimination Policy

Notice of Privacy Practices

Nurse Advice Line

Online Provider Directory Tutorial

Online Self-Service

Order ID Card, Member Handbook and Provider Directory

Organizational Provider Application

Other Health Coverage (OHC) Referral Form

Other Services

Our Test Page

Outpatient Clinical Laboratory Provider Application

Pain Management and Substance Use Resources

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 Forms

Pharmacy Formulary

Pharmacy Services

Physical Accessibility Review Survey

Physician Certification Statement of Medical Necessity for NEMT

Physician Orders for Life-Sustaining Treatment (POLST)

Plan All-Cause Readmissions Tip Sheet


Prescription Drug Prior Authorization or Step Therapy Exception Request Form

Prescription Drugs and Pharmacy Benefits

Preventable Emergency Care Visit Diagnosis Tip Sheet

Preventable Emergency Visits Tip Sheet

Prevention and Self-Management Programs

Primary Care

Prior Authorization Criteria

Prior Authorization Information Request for Injectable Drugs

Privacy Request

Procedure Code Lookup Tool

Procedure Reimbursement Rate Request

Programmatic Measure Benchmarks & Performance Improvement

Promoting Cultural and Linguistic Competency

Provider Application Request

Provider Approval Checklist Diabetes Prevention & Self Management Education

Provider Change Request (PCR)

Provider Compliance Concern Report

Provider Credentialing Applications and Policies

Provider Directory

Provider Directory

Provider Event Submission

Provider Events Calendar

Provider Identified Overpayment Form

Provider Information Change Form

Provider Inquiry Form

Provider Manual

Provider News

Provider News Archives

Provider News Posts

Provider Portal

Provider Portal Account Request Form

Provider Portal Account Request Form – Step 2

Provider Portal Frequently Asked Questions

Provider Portal Quick Reference

Provider Portal User Guide

Provider Recruitment Program

Provider Resources

Public Meetings

Quality of Care

Quitting Tobacco

Remittance Advice Explain Codes

Remittance Advice Guide

Request for Member Reassignment Form