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Drug Medi-Cal Organized Delivery System

Welcome to the County of San Diego’s Behavioral Health Services (BHS) Drug Medi-Cal Organized Delivery System (DMC-ODS) document library. From this site you will be able to access any communications, forms, and manuals that BHS has sent out to providers. If you are looking for more general information regarding DMC-ODS, please visit the BHS DMC-ODS website by clicking here.  

Training

If you are provider and are looking for a comprehensive list of required provider trainings for DMC-ODS, click here to visit the DMC-ODS Training site.

SUDPOH

1 - SUDPOH (pdf)
Updated 6-13-20 2020-07-06
2 - Summary of Changes (pdf)
Updated 6-13-20 2020-07-06
3 - Appendix D.4 - Group Counseling Sign In Sheet (pdf)
Updated 06-06-19 2019-06-11
4 - Appendix E.4 - Program Accessibility Assessment (docx)
2018-07-11
5 - Appendix F.2 - Gift Card Approval Form (xlsx)
2017-10-16
6 - Appendix F.4 - Payment Recovery Form (Void-Disallowance) (xlsx)
Updated 06-15-2019 2019-07-22
7 - Appendix F.5 - BHS Inventory Form (pdf)
2020-07-06
8 - Appendix F.6 - DPC 203 (Fillable) (pdf)
2019-07-22
9 - Appendix F.7 - DPC 203 Mobile Devices (xls)
2019-07-22
10 - Appendix F.8 - DPC 203 Mobile Devices Supplemental (xls)
2018-08-22
11 - Appendix G.1 - Root Cause Analysis Worksheet (doc)
2018-07-11
12 - Appendix - G.2 - Serious Incident Report of Findings (SIROF) (pdf)
Updated 1-13-20 2020-07-06
13 - Appendix G.3 - Serious Incident Report (SIR) (pdf)
2020-07-06
14 - Appendix G.5 - SUD Complaint Form (docx)
2018-08-22

SUDURM

00 – SUD Uniform Record Manual 07-01-19 (pdf)
2019-09-03
01 – Uniform Record Manual 07-01-19 (pdf)
Revised July 2019 2019-07-31
02 - Client File Order 07-01-19 (pdf)
2019-07-24
02 ‐ Client File Order 05‐01‐2020 (pdf)
Revised May 2020 2020-05-14
03 - Section 1 Detail 01-14-19 (pdf)
2019-02-11
101a Instruction Client Tracking 07-01-19 (pdf)
2019-07-26
101b Client Tracking 07-01-19 (pdf)
2019-07-26
103 Instruction Medi-Cal Eligibility Printout (pdf)
2019-02-11
104a Instruction Supplement Minor Children 04-12-17 (pdf)
2018-01-24
104a Minor Children Form 04-12-17 (pdf)
2018-01-24
104b-1 Instructions Brief Level of Care Screening Tool 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104b-2 Brief Level of Care Screening Tool Hard Copy 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104b-3 Brief Level of Care Screening Tool Form Fill 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104c-1 Instructions Adult Initial Level of Care Assessment 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104c-2 Adult Initial LOC Assessment Hard Copy 05-01-2020 (pdf)
Revised May 2020 2020-05-18
104c-3 Adult Initial LOC Assessment Form Fill 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104d-1 Instructions Adolescent Initial Level of Care Assessment 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104d-2 Adolescent Initial LOC Assessment Hard Copy 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104d-3 Adolescent Initial LOC Assessment Form Fill 05-01-2020 (pdf)
Revised May 2020 2020-05-14
104e-1 Instructions Parent Guardian Initial Level of Care Assessment 07-01-19 (pdf)
2019-07-26
104e-2 Parent Guardian Initial LOC Assessment Form Fill 07-01-19 (pdf)
2019-07-26
104e-2 Parent Guardian Initial LOC Assessment Hard Copy 07-01-19 (pdf)
2019-07-26
105 Placement Fee Collection 4-12-17 (pdf)
2017-05-01
106 Placement-ID-SS-Medi Cal Cards (pdf)
2018-07-06
107a Instruction Financial Responsibility Info and MC SOC 05-01-2020 (pdf)
Revised May 2020 2020-05-14
107b Financial Responsibility Information and MC SOC 05-01-2020 (pdf)
Revised May 2020 2020-05-14
108 Placement - SanWITS Admission Profile 01-14-19 (pdf)
2019-02-11
200 Section 2 Detail 07-01-19 (pdf)
2019-07-26
201 Placement-consent to release 07-01-19 (pdf)
2019-07-26
202 Placement-Admissions Agreement-Consent to Treatment 4-12-17 (pdf)
2017-05-01
203a Instructions Client Rights and Complaints 05-01-2020 (pdf)
Revised May 2020 2020-05-14
203b Client Rights and Complaints 05-01-2020 (pdf)
Revised May 2020 2020-05-14
204 Placement-42 CFR Written Summary Requirements 7-2-18 (pdf)
2018-07-06
205 Placement-Notice of Privacy-HIPAA 4-12-17 (pdf)
2017-05-01
206 Placement-Consent to Follow up 4-12-17 (pdf)
2017-05-01
207 Placement-Consent for photo-tv-video 4-12-17 (pdf)
2017-05-01
209a Instruction Acknowledgement of DMC-ODS Handbook Practice Guidelines and Provider Directory 03-07-19 (pdf)
2019-03-21
209b Acknowledgement of DMC-ODS Beneficiary Handbook Practice Guidelines and Provider Directory 03-07-19 (pdf)
2019-03-21
210a Instructions SUD Program Admission Checklist 6-27-18 (pdf)
2018-07-06
210b SUD Program Admission Checklist 05-01-2020 (pdf)
Revised May 2020 2020-05-14
300 Section 3 Detail 7-3-18 (pdf)
2018-07-06
301a Instruction Justification for Continuing Services 05-01-2020 (pdf)
Revised May 2020 2020-05-14
301c Justification for Continuing Services Form Fill 07-01-19 (pdf)
2019-09-03
301c Justification for Continuing Services Hard Copy 07-01-19 (pdf)
2019-07-26
302a Instruction Alcohol and Drug Hx 4-12-17 (pdf)
2017-05-01
302b Alcohol and Drug History Form 4-12-17 (pdf)
2017-05-01
303a Instruction ASI-YAI 01-11-19 (pdf)
2019-02-11
303c ASI Lite (pdf)
2017-04-27
303d YAI (pdf)
2018-09-11
304a Instruction Co-occurring Form 4-12-17 (pdf)
2017-05-01
304b Co-occurring Screening Form 4-12-17 (pdf)
2017-04-27
304c Form Fill Co-occurring Screening Form 4-12-17 (doc)
2017-04-27
305a-1 Instruction Risk Assessment and Safety Management Plan 06-06-19 (pdf)
Revised 06-06-19 2019-07-22
305a-2 Risk Assessment and Safety Management Plan 06-06-19 (pdf)
2019-07-22
305b-1 Instruction High Risk Assessment 06-06-19 (pdf)
Revised 06-06-19 2019-07-22
305b-2 High Risk Assessment 06-06-19 (pdf)
2019-07-22
306a Instructions Level of Care Recommendation 05-01-2020 (pdf)
Revised May 2020 2020-05-14
306b Level of Care Recommendation 05-01-2020 (pdf)
Revised May 2020 2020-05-14
307a Instructions Assessment Summary 01-11-19 (pdf)
2019-02-11
307b Assessment Summary 06-26-18 (pdf)
2018-07-06
307c Assessment Summary Form Fill 06-26-18 (pdf)
2018-07-06
308a Instructions Diagnosis Determination Note 01-11-19 (pdf)
2019-02-11
308b Dx Determination Note Hard Copy 07-01-19 (pdf)
2019-07-26
308c Dx Determination Note Form Fill 07-01-19 (pdf)
2019-09-03
400 Section 4 Detail 01-14-19 (pdf)
2019-02-11
401a Instruction WM Observation Log 11-26-19 (pdf)
2019-12-02
401b Withdrawal Observation Log 11-21-19 (pdf)
2019-12-02
402a Instruction Centrally Stored Medication & Destruction Record 4-12-17 (pdf)
2018-07-06
402b Centrally Stored Medication and Destruction Record (pdf)
2017-04-27
403a Instruction Health Questionnaire Form 9-30-18 (pdf)
2018-10-11
403b Health Questionnaire 09-25-18 (pdf)
2018-10-11
404a Instruction TB questionnaire 01-11-19 (pdf)
2019-02-11
404b TB screening form 4-12-17 (pdf)
2017-05-01
406 Physician Direction Form 4-12-17 (pdf)
2017-05-01
406a Instruction Physician Direction form 01-09-19 (pdf)
2019-02-11
407 MD Recomendation to client 4-12-17 (pdf)
2017-05-01
407a Placement - Physical Exam Results 05-01-2020 (pdf)
Revised May 2020 2020-05-14
408 Placement - Proof of Pregnancy 01-11-19 (pdf)
2019-02-11
500 Section 5 Detail 01-14-19 (pdf)
2019-02-11
501a Instructions Initial Treatment Plan 05-01-2020 (pdf)
Revised May 2020 2020-05-14
501b Initial Treatment Plan 05-01-2020 (pdf)
Revised May 2020 2020-05-14
502a Instructions Updated Treatment Plan 05-01-2020 (pdf)
Revised May 2020 2020-05-14
502b Updated Treatment Plan 05-01-2020 (pdf)
Revised May 2020 2020-05-14
503a Instructions Treatment Plan Addendum 01-11-19 (pdf)
2019-02-11
503b Treatment Plan Addendum (pdf)
Revised 08/06/2018 2020-01-06
504a Instructions Recovery Plan (pdf)
2019-03-18
504b Recovery Plan Worksheet (pdf)
2019-03-18
505a Instructions Treatment Effectiveness Assessment 01-09-19 (pdf)
2019-02-11
505b Treatment Effectiveness Assessment 01-09-19 (pdf)
2019-02-11
506a Instructions WM TX Plan for DMC‐ODS 05‐01‐2020 (pdf)
Revised May 2020 2020-05-14
506b WM Tx Plan for DMC‐ODS 05‐ 01‐2020 (pdf)
Revised May 2020 2020-05-14
600 Section 6 Detail 01-15-19 (pdf)
2019-02-11
601a Instructions SUD Treatment Progress Note 07-01-19 (pdf)
2019-07-26
601b SUD Treatment Progress Note - Hard Copy 07-01-19 (pdf)
2019-07-24
601c SUD Treatment Progress Note - Form Fill 07-01-19 (pdf)
2019-07-24
602a-1 Instructions for Residential Weekly Progress Note - Narrative 01-24-19 (pdf)
2019-02-11
602a-2 Weekly Progress Note Residential - Narrative - Hard Copy 6-27-18 (pdf)
2018-07-06
602a-3 Weekly Progress Note Residential - Narrative - Form Fill 6-27-18 (pdf)
2018-07-06
602b-1 Instructions for Residential Weekly Progress Note - Services 01-24-19 (pdf)
2019-02-11
602b-2 Weekly Progress Note Residential – Service 06-19-18 (pdf)
2020-08-04
603a Instructions Residential WM Daily Progress Note 10-5-18 (pdf)
2018-10-11
603b Residential WM Daily Progress Note – Hard Copy 10-05-18 (pdf)
2018-10-11
603c Residential WM Daily Progress Note Form Fill 10-03-18 (pdf)
2018-10-11
604a Instructions Outpatient Group Progress Note 07-01-19 (pdf)
2019-10-10
604b Outpatient Group Progress Note Hard Copy 07-01-19 (pdf)
2019-07-26
604c Outpatient Group Progress Note Form Fill 07-01-19 (pdf)
2019-07-26
605a Instructions Other Progress Note 03-18-2020 (pdf)
2020-03-18
605b Other Progress Note - Hard Copy 03-18-2020 (pdf)
2020-03-18
605c Other Progress Note - Form Fill 03-18-2020 (pdf)
2020-03-18
700 Section 7 Detail 01-15-19 (pdf)
2019-02-11
701a Instructions Discharge Summary 07-01-19 (pdf)
2019-07-26
701b Discharge Summary - Hard Copy 07-09-2019 (pdf)
2019-07-26
701c Discharge Summary - Form Fill 07-09-2019 (pdf)
2019-07-26
703 Placement - SanWITS Discharge Profile 01-14-19 (pdf)
2019-02-11
704a Instruction Client Discharge Plan 4-12-17 (pdf)
2017-05-01
704b Client Discharge Plan 07-01-19 (pdf)
2019-07-26
800 Section 8 Detail 01-15-19 (pdf)
2019-02-11
801a Instruction Drug Test and Results Log 01-11-19 (pdf)
2019-02-11
801b Drug Test and Result Log Form (pdf)
2017-05-01
802 placement Drug Test Results From Lab 4-12-17 (pdf)
2017-05-01
803 placement Progress Reports (pdf)
2017-05-01
805 placement Referral Source Documents (pdf)
2017-05-01
806a FAX COVER SHEET FOR RSUD AUTH (docx)
Revised 01/29/2020 2020-02-11
807 Placement - SanWITS Residential Authorization Printout (pdf)
2019-02-11

Communications

QM Memo – State Fair Hearing COVID Waiver (pdf)
04/16/2020 2020-05-12
3/19/20 BHS Provider Notice #3- COVID 19- Quality Improvement Updates and Best Practices (pdf)
2020-03-20
QM Memo – DSM 5 Diagnoses in SanWITS (pdf)
Issued 01/22/2020 2020-01-27
Info Notice – BHS 2020-002 - DMC-ODS Clients with Other Health Coverage (pdf)
Issued 01/15/2020 2020-01-16
Info Notice - BHS 2020-002 Assign Insurance Benefits Form (pdf)
Revised 05/20/2019 2020-01-16
QM Memo - Transitional Care Services (pdf)
Issued 12/23/2019 2020-01-07
Info Notice – Extension of DMC Billable Unit Production Plan.pdf
Dec 19, 2019 2019-12-23
401b Withdrawal Observation Log 11-21-19 (pdf)
2019-12-05
401a Instruction WM Observation Log (pdf)
2019-12-05
Memo – DMC-ODS Travel Time Guidelines (pdf)
Updated 10-21-19 2019-10-22
Email – SUD Providers – Requirements for Policy and Procedure Development Monitoring (pdf)
2018 02/23 Emailed 2019-10-10
QM Memo - Physical Exam Requirements (pdf)
2019 10/02 Issued 2019-10-03
Info Notice - DMC-ODS – Total Units of Service (TUOS) Report Distribution (pdf)
2019 08/13 Issued 2019-08-14
Email - FY 19-20 DMC-ODS Interim Rates (pdf)
2019 07/01 Issued 2019-08-14
QM Memo - Residential Authorization Request Timelines
2019 08/05 Issued 2019-08-12
Info Notice - Amended Process for Out-of-County Clients – OTP Out of County MCal Tip Sheet (pdf)
July 1, 2019 2019-07-24
Info Notice - Amended Process for Out-of-County Clients – Outpatient Out of County MCal Tip Sheet (pdf)
July 1, 2019 2019-07-24
Info Notice - Amended Process for Out-of-County Clients – Residential BD Out of County MCal Tip Sheet (pdf)
July 1, 2019 2019-07-24
Info Notice - Unit Production Plan (pdf)
June 17, 2019 2019-07-24
Info Notice - Amended Process for Out-of-County Clients – Residential CM Out of County MCal Tip Sheet (pdf)
July 1, 2019 2019-07-24
Info Notice - Amended Process for Out-of-County Clients – Out-of-County Flowchart (pdf)
July 1, 2019 2019-07-24
Info Notice - Amended Process for Out-of-County Clients (pdf)
July 1, 2019 2019-07-24
Info Notice - DMC-ODS FY 18-19 Data Entry Requirements
06/28/2019 2019-07-18
Info Notice - Unit Production Plan (Q4) (pdf)
2019 04/04 Emailed 2019-04-10
Memo – SanWITS DMC-ODS Data Entry Standards (pdf)
2019 03/29 Emailed 2019-04-02
Info Notice – Share of Cost Process (pdf)
2019 02/01 Issued 2019-02-06
Info Notice - Rate Cap Waiver Extension (Q3) (pdf)
2018 12/18 Emailed 2018-12-20
Compliance Bulletin #30 - Cloned Documentation - 11-1017 (pdf)
2011 10/17 Issued 2018-12-06
Memo – Patient Advocacy Services for BHS – Record Requests (pdf)
2018 10/31 Emailed 2018-11-02
Memo – Assessed No Admit and Assess Delayed Admit 10-18 (pdf)
2018 10/19 Issued 2018-10-26
Info Notice – BHS 2018-014 Timely Admissions for Collaborative Court Participants (pdf)
2018 10/19 Issued 2018-10-26
Email - BHS 2018-014: Timely Admissions for Collaborative Court Participants (pdf)
2018 10/12 Emailed 2018-10-19
Email – SUD Providers – Extension of Transition Plan (County Billable Services) (pdf)
2018 07/23 Emailed 2018-10-04
Info Notice - Rate Cap Waiver Extension (pdf)
2018 09/19 Emailed 2018-10-02
Email – SUD Providers – County Billable Services for July 2018 (pdf)
2018 07/13 Emailed 2018-10-02
Initial Billing Compliance Reviews (pdf)
2018-09-26
Memo - QI SUD Provider Updates (pdf)
2018 08/16 Issued 2018-08-22
Info Notice - Rate Cap Waiver for First Quarter (Q1) (pdf)
2018 08/07 Issued 2018-08-09
Info Notice - Timely Access to Services (pdf)
2018 07/31 Issued 2018-08-06
Info Notice - Process for Out-of-County Clients (pdf)
2018 07/30 Issued 2018-08-06
Info Notice - DMC-ODS Twice-a-Month Invoice Process (pdf)
2018 07/02 Issued 2018-07-09
Email - Updated SUDURM Forms Effective July 1, 2018 (pdf)
2018 06/27 Emailed 2018-07-09
Email - DMC-ODS SUDPOH Overview on June 14, 2018 - Questions and Answers (pdf)
2018 06/29 Emailed 2018-07-09
Email - ASAM Training Log Update Request and New ASAM C Training on July 18, 2018
2018 06/25 Emailed 2018-07-09
Info_Notice_-_Reentry_and_Drug_Courts_SUD_Treatment_Services.pdf
2018 06/13 Issued 2018-06-15
Info_Notice_-_DMC-ODS_Court_Ordered_Residential_Treatment_-_Follow-Up.pdf
2018 06/12 Issued 2018-06-12
Info_Notice_-_DMC-ODS_Training_Requirements_and_Waiver_Resources.pdf
2018 03/19 Issued 2018-06-06
Info_Notice_-_DMC-ODS_Court_Ordered_Residential_Treatment.pdf
2018 05/17 Issued 2018-06-06
Letter_-_Updates_on_the_BHS_DMC-ODS_Implementation.pdf
2017 01/07 Issued 2018-06-06
Letter_-_Preparing_for_Contracting_under_the_DMC-ODS.pdf
2017 10/24 Issued 2018-06-06
Info_Notice_-_Start-up_Enhancements_for_FY_17-18_and_FY_17-18_-_Attachment_1.xlsx
2018 01/31 Issued 2018-06-06
Info_Notice_-_Start-up_Enhancements_for_FY_17-18_and_FY_17-18.pdf
2018 01/31 Issued 2018-06-06
Info_Notice_-_FY_17-18_Start-up_Cost_Amendment_-_Attachment_2.xlsx
2018 01/12 Issued 2018-06-06
Info_Notice_-_FY_17-18_Start-up_Cost_Amendment_-_Attachment_1.xlsx
2018 01/12 Issued 2018-06-06
Info_Notice_-_FY_17-18_Start-up_Cost_Amendment.pdf
2018 01/12 Issued 2018-06-06
Info_Notice_-_FY_17-18_DMC-ODS_Enhancement_Budget-Invoice_Process_-_Attachment_3.xlsx
2018 04/05 Issued 2018-06-06
Info_Notice_-_FY_17-18_DMC-ODS_Enhancement_Budget-Invoice_Process_-_Attachment_2.xlsx
2018 04/05 Issued 2018-06-06
Info Notice - FY 17-18 DMC-ODS Enhancement Budget-Invoice Process - Attachment 1 (pdf)
2018 05/17 Issued 2018-06-06
Info_Notice_-_FY_17-18_DMC-ODS_Enhancement_Budget-Invoice_Process.pdf
2018 04/05 Issued 2018-06-06

QM Training

Program Integrity Webinar
00 – Archived List – QM Training (pdf)
September 10, 2020 2020-09-11
01 – DHCS DMC Certification PAVE (pdf)
2019-06-20
02 – DHCS DMC Certification PAVE Video Transcript (pdf)
2019-06-20
03 – DHCS DMC Certification PAVE Support Resources Table (pdf)
2019-06-20
09 - Example 3.1 ASAM LOC Recommendation (pdf)
2018-08-30
10 - Example 3.1 Initial LOC Assessment (pdf)
2018-08-30
11 – Example 3.5 Initial LOC Assessment (pdf)
2018-08-30
12 – Example 3.5 Initial Treatment Plan (pdf)
2018-08-30
13 - Example Residential Weekly Progress Note Narrative and Services (pdf)
2018-10-26
14 – Example Residential or WM Daily Progress Note (pdf)
2018-10-26
15 - Example SUD Treatment Progress Note - Case Management (pdf)
2018-10-26
16 - QM Memo - SUD Providers - Beneficary Rights Webinar (pdf)
Revised 06/04/2019 2019-06-05
17 - Module 1: Introduction to DMC-ODS (pdf)
Revised 5/19/20 2020-05-21
18 – Module 2 – Medical Necessity (pdf)
Revised 05-20-2020 2020-05-22
19 – Module 3: Treatment Planning for Substance Use Disorders (pdf)
Revised 5-21-20 2020-06-09
20 – Module 4: SUD Services in Residential (pdf)
Revised 5-21-20 2020-06-09
21 – Module 5: SUD Services in Outpatient (pdf)
Revised 5-22-20 2020-06-10
22 – Module 6: Progress Notes Documentation (pdf)
Revised 6/17/20 2020-09-17
23 - Module 7 – Discharge and Care Coordination (pdf)
Revised 5/5/20 2020-05-11
24 – Module 8: Recovery Services (pdf)
Revised 4/7/20 2020-04-08
25 – Module 9: Withdrawal Management (pdf)
2020-05-28
26 – Module 10: Case Management (pdf)
2020-06-04
27 – Quality Assurance Review Webinar (pdf)
Revised 07-03-19 2019-07-08

Manuals

Special_Terms_and_Conditions_-_Amended_Apr_5_2018.pdf
Updated Apr 5 2018 2018-06-21
County of San Diego DMC-ODS Implementation Plan.pdf
County of San Diego DMC-ODS Implentation Plan Appendix.pdf
00 – Archived List – Manuals (pdf)
September 10, 2020 2020-09-11
County of San Diego DMC-ODS Intergovernmental Agreement Contract 2019
Updated 2019 2019-05-13
DHCS AOD Program Certification Standards (pdf)
February 2020 2020-08-26
DHCS Perinatal Practice Guidelines (pdf)
2020-07-17
DHCS Youth Treatment Guidelines (pdf)
Updated August 2002 2018-09-27
DMC-ODS Provider Services Guide (pdf)
2018-09-10

Toolbox

One-Pager_-_Case_Management_in_the_DMC-ODS.pdf
Updated Jun 8 2018 2018-06-12
One-Pager_-_DMC-ODS_Required_Policies_and_Procedures.pdf
Updated Jun 8 2018 2018-06-12
One-Pager_-_Programs_with_Multiple_Contracts.pdf
Updated May 14 2018 2018-06-15
One-Pager_-_Recovery_Services_in_the_DMC-ODS.pdf
Updated Oct 17 2017 2018-06-15
2019-2020 Reasons for Disallowance (pdf)
2019-08-05
ASAM Level of Care Guidelines (pdf)
2018-11-08
DHCS Toolkit – MAT in Residential Treatment Facilities (pdf)
2020-09-21
DMC-ODS SUD Provider Operations Resource Guide (pdf)
2019-01-31
In-custody SUD Tx Self-Referral form 10-16-18 (pdf)
2018-10-26
Invoicing – DMC-ODS Residential Providers (pdf)
June 27, 2019 2019-06-28
One-Pager DMC-ODS Documentation Changes (pdf)
Updated Jun 18 2018 2018-06-20
Outpatient Due Date Timelines - Standard Year (pdf)
2019-11-07
Outpatient Due Date Timelines – Leap Year (pdf)
Revised 6/3/20 2020-06-04
Outpatient Due Date Timelines – Standard Year Immediately Preceding Leap Year (pdf)
2020-04-29
Quick Guide - DMC-ODS Client Flow Process (pdf)
2018-09-10
Quick Guide - DSM5-ICD10 Diagnosis Guide (pdf)
Updated Jun 12 2018 2018-06-22
Quick Guide - Minimum Quality Drug Treatment Standards for DMC/SABG (pdf)
Updated Jun 12 2018 2018-06-22
Quick Guide - Residential Due Dates (pdf)
2018-08-10
Quick Guide - Residential Services (pdf)
2018-08-14
Quick Guide - SUD Residential Clinical Documentation and Authorization (pdf)
Updated May 14 2018 2018-06-20
Quick Guide - Same Day Billing Matrix (pdf)
Updated Jun 19 2018 2018-06-22
Quick Guide – Case Management Activities (pdf)
Revised March 2020 2020-03-18
Residential Due Date Timelines - Leap_Year (pdf)
2019-11-07
Residential Due Date Timelines - Standard Year (pdf)
2019-11-07
Residential Due Date Timelines – Standard Year Immediately Preceding Leap Year (pdf)
2020-04-29
Transportation Guidelines (pdf)
Updated 10-25-19 2019-10-28
Withdrawal Management Standards (pdf)
Revised 4/8/20 2020-04-30

Beneficiary

Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Arabic.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__English.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Farsi.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Spanish.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Tagalog.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Vietnamese.mp3
For use after Jul 1 2018 2018-06-20
Brochure_-_Grievance_and_Appeal_Process_-_English.pdf
For use after Jul 1 2018 2018-06-29
Limited_English_Proficiency_Poster_Vietnamese_07-10-18.pdf
2019-01-28
Limited_English_Proficiency_Poster_Tagalog_07-10-18_.pdf
2019-01-28
Limited_English_Proficiency_Poster_Spanish_07-10-18.pdf
2019-01-28
Limited_English_Proficiency_Poster_Farsi_07-10-18.pdf
2019-01-28
Limited_English_Proficiency_Poster_English_07-10-18.pdf
2019-01-28
Limited_English_Proficiency_Poster_Arabic_07-10-18.pdf
Brochure – Grievance and Appeal Process 6-28-18 Arabic (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Farsi (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Spanish (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Tagalog (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Vietnamese (pdf)
2018-08-15
DMC-ODS Beneficiary Handbook Large Print – English (pdf)
2019-02-14
DMC-ODS Beneficiary Handbook – Arabic (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Arabic LG Print (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – English (pdf)
2019-02-14
DMC-ODS Beneficiary Handbook – Farsi (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Farsi LG Print (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Spanish (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Spanish LG Print (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Tagalog (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Tagalog LG Print (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Vietnamese (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Handbook – Vietnamese LG Print (pdf)
Updated 12-07-2018 2019-03-20
DMC-ODS Beneficiary Packet Materials Order Form 05-09-19 (pdf)
2019-05-13
DMC-ODS Beneficiary Packet Order Form rev 10-22-18 (pdf)
2018-10-26
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Arabic (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 English (docx)
2018-06-29
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Farsi (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Spanish (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Tagalog (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Vietnamese (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Arabic (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 English (docx)
For use after Jul 1 2018 2018-06-29
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Farsi (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Spanish (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Tagalog (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Vietnamese (docx)
2018-08-15
Poster – Grievance and Appeal 03-06-19 Arabic (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 English (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Farsi (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Spanish (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Tagalog (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Vietnamese (pdf)
2020-03-12
Poster – Grievance and Appeal English LARGE FONT 03-05-19 (pdf)
2020-03-12
Quick Guide - How To Apply for Medi-Cal (pdf)
2018-11-27
Quick Guide – DMC-ODS Services in San Diego - Arabic (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - English (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Farsi (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Spanish (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Tagalog (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Vietnamese (pdf)
Updated 03-04-2019 2019-03-05

NOABD

NAR_Adverse_Benefit_Determination_Upheld_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Modification_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ENGLISH.docx
- 2018-08-07
NOABD_Timely_Access_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_TAGALOG.docx
- 2018-08-07
Notice_of_Grievance_Resolution_-_ARABIC.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Denial_Notice_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_TAGALOG.docx
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_SPANISH.pdf
2018-08-06
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Modification_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_ARABIC.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_FARSI.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.pdf
- 2018-08-07
NOABD_Denial_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Termination_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_FARSI.pdf
- 2018-08-07
NOABD_Modification_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ARABIC.docx
- 2018-08-07
Notice_of_Grievance_Resolution_-_TAGALOG.docx
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.pdf
- 2018-08-07
NOABD_Modification_Notice_-_FARSI.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.doc
2018-08-06
NAR_Your_Rights_State_Hearing_-_SPANISH.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Denial_Notice_-_SPANISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.docx
2018-08-06
NOABD_Your_Rights_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_VIETNAMESE.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.pdf
- 2018-08-07
Notice_of_Grievance_Resolution_-_ENGLISH.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_SPANISH.pdf
- 2018-08-07
NOABD_Financial_Liability_Notice_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_ENGLISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.pdf
- 2018-08-07
Notice_of_Grievance_Resolution_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Denial_Notice_ENGLISH.doc
2020-06-12
Beneficiary_Non-Discrimination_Notice_-_FARSI.pdf
2018-08-06
NAR_Your_Rights_State_Hearing_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_FARSI.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.pdf
2018-08-06
NAR_Your_Rights_State_Hearing_-_SPANISH.pdf
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_SPANISH.docx
2020-06-12
NOABD_Termination_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Termination_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Termination_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Termination_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_VIETNAMESE.docx
- 2018-08-07
NOABD_Modification_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Modification_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Financial_Liability_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_ENGLISH.pdf
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_TAGALOG.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_ARABIC.pdf
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Denial_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ENGLISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_FARSI.doc
2018-08-06
NOABD_Payment_Denial_Notice_-_FARSI.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_SPANISH.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ARABIC.pdf
2018-08-06
NOABD_Denial_Notice_-_ARABIC.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.pdf
2018-08-06
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Termination_Notice_-_FARSI.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_SPANISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_ARABIC.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ENGLISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_ENGLISH.pdf
2018-08-07

UTTM

SUD Up to the Minute - August 2020 (pdf)
2020 2020-08-20
SUD Up to the Minute - September 2020 (pdf)
2020 2020-09-14
SUD Up to the Minute - July 2020 (pdf)
2020 2020-07-16
SUD Up to the Minute - May 2020 (pdf)
2020 2020-05-18
SUD Up to the Minute - June 2020 (pdf)
2020 2020-07-10
SUD Up to the Minute - December 2018 (pdf)
2018-12-13
SUD Up to the Minute - April 2020 (pdf)
2020 2020-04-14
SUD Up to the Minute - November 2018 (pdf)
2018-12-06
SUD Up to the Minute – September 2019 (pdf)
2019-09-17
SUD Up to the Minute – August 2019 (pdf)
2019-08-21
SUD Up to the Minute - September 2018 (pdf)
2018-09-20
SUD Up to the Minute - March 2020 (pdf)
2020 2020-03-17
SUD Up to the Minute - October 2018 (pdf)
2018-10-15
SUD Up to the Minute - April 2019 (pdf)
2019-04-12
SUD Up to the Minute – November 2019 (pdf)
2019-11-13
SUD Up to the Minute - May 2019 (pdf)
2019-05-13
SUD Up to the Minute - January 2020 (pdf)
2020 2020-01-22
SUD Up to the Minute -February 2020 (pdf)
2020 2020-03-02
SUD Up to the Minute – June 2019 (pdf)
2019-06-13
SUD Up to the Minute – July 2019 (pdf)
2019-07-31
SUD Up to the Minute - March 2019 (pdf)
2019-03-20
SUD Up to the Minute - October 2019 (pdf)
2019-10-10
SUD Up to the Minute - December 2019 (pdf)
2020-01-07
SUD Up to the Minute – February 2019 (pdf)
2019-02-15
SUD Up to the Minute - January 2019 (pdf)
2019-01-10
SUD Up to the Minute 2018 Year-End Summary (pdf)
2019-01-02

SanWITS

For versions of the UTTM prior to September 2018, please see the “UTTM” tab on the Organizational Provider Public Documents page.
Tip Sheet – OTP Reimbursement Rates Clarification (pdf)
Revised 9/23/20 2020-09-23
Tip Sheet - DSM 5 Diagnostic Labels in SanWITS (pdf)
Revised 9/21/20 2020-09-22
SanWITS User Modification or Termination Form (pdf)
Revised 9/11/20 2020-09-21
SanWITS New User Form (pdf)
Revised 9/11/20 2020-09-21
Intro to Admin Functions Training Manual (pdf)
Revised 08/23/2020 2020-08-31
Tip Sheet – TUOS Claim Summary Report (pdf)
Created 6/16/20 2020-07-17
Tip Sheet – Residential Bed Day Claim Summary Report (pdf)
Created 6/18/20 2020-07-01
Tip Sheet – Drug Court Programs Workflow (pdf)
Revised 06/24/20 2020-06-25
SanWITS Flow Chart for Encounters Released to Bill and Placed on Hold (pdf)
Created 5/27/20 2020-06-15
SanWITS Flow – Group List for Outpatient Providers (pdf)
Revised 6/11/20 2020-06-12
Memo – SanWITS DMC-ODS_Data_Entry_Standards (pdf)
Revised 2/11/20 2020-04-23
DHCS Application Portal User Manual (pdf)
2020-04-21
DATAR Rewrite User Manual (pdf)
2020-04-21
Residential Encounters and Group Modules Training Manual (pdf)
Revised 03/30/2020 2020-04-01
Outpatient Encounters and Group Modules Training Manual (pdf)
Revised 03/26/2020 2020-03-27
Tip Sheet – Services provided via Telehealth (pdf)
Created 3/20/20 2020-03-25
Tip Sheet – Changing Level of Care (pdf)
2020-03-06
Tip Sheet - Steps for Disallowed Services (pdf)
Created 08/23/2019 2020-02-06
Tip Sheet - Transitional Care Services Program Enrollment (pdf)
Created 12/20/2019 2019-12-31
Forms - CalOMS Profile S108A and S108B (pdf)
2019-12-12
Forms - CalOMS Annual Update S112 (pdf)
2019-12-12
Forms - CalOMS Admission S111 (pdf)
2019-12-12
Forms - CalOMS Discharge S703 (pdf)
2019-12-12
Forms - SanWITS Encounter S113 (pdf)
2019-12-12
Forms - SanWITS Intake S110 (pdf)
2019-12-12
Forms - SanWITS Contact S109 (pdf)
2019-12-12
CalOMS Tx Data Dictionary April 2018 (pdf)
2019-12-11
Tip Sheet - NOABD (Notice of Adverse Benefit Determination) (pdf)
Created 08/06/2019 2019-10-25
Tip Sheet - Program Enrollment for NON BHS Contracted Clients (pdf)
Revised 08/12/19 2019-08-16
Tip Sheet - Residential Service Claims and Payor Group Enrollment (pdf)
Updated 05/30/2019 2019-08-05
Tip Sheet - Outpatient Service Claims and Payor Group Enrollment (pdf)
Updated 05/30/2019 2019-08-05
How to – Configure a Digital ID for Signing (pdf)
2019-07-08
SanWITS - Access to Service Data Collection Tip-Sheet (pdf)
Updated 6/27/2019 2019-07-01
SanWITS SSRS Tip Sheet Run Reports (pdf)
2019-06-21
SanWITS Report Request Form (pdf)
2019-06-04
Webinar – TUOS Announcement New Reports for Invoicing (pdf)
2019-05-29
Webinar – TUOS Group Session ID (pdf)
2019-05-29
Webinar – TUOS Summary and Detail Invoicing Demo (pdf)
2019-05-29
Service Claims and Payor Group Enrollment New Procedure (pdf)
MIS Informational Notice 2019-05-01
SanWITS Flow for Opioid Treatment Providers
SanWITS Flow – Group List for Outpatient Providers (pdf)
2019-02-07
SanWITS Flow – Group List for OTP Providers (pdf)
2018-11-02
CalOMS Tx Data Collection Guide Jan 2014 (pdf)
2018-09-12
SanWITS Flow Assessed – Delayed Admit (pdf)
2018-10-26

Billing

BHS_Drug_Medi-Cal_Organizational_Providers_Billing_Manual.pdf
Updated Jun 18 2018 2018-06-21
Assignment of Insurance Benefits Form (pdf)
Revised 05-20-19 2019-07-22
BU Tip Sheet - Releasing Residential Case Management to OHC and Printing CMS 1500 Form (pdf)
2020-08-05
BU Tip Sheet – Releasing Outpatient to OHC and Printing CMS 1500 Form (pdf)
2020-08-05
DHCS 100186 Instructions (pdf)
How to complete the form 2020-09-25
DHCS 100186 or Claim Submission Certification Form (pdf)
Required billing certification form when submitting claim batch 2020-09-25
DHCS Drug Medi-Cal Billing Manual (pdf)
Updated April 2019 2019-04-29
Disallowance After Release to Billing OTP (pdf)
2019-10-28
Disallowance After Release to Billing Outpatient (pdf)
2019-09-26
Disallowance After Release to Billing Residential BD (pdf)
2019-09-26
Disallowance After Release to Billing_Residential Case Mgt (pdf)
2019-09-26
OTP Billing SanWITS Screens 11-21-2018 (pdf)
2018-12-06
Outpatient Provider Billing SanWITS Screens (pdf)
Revised 06-14-2019 2019-06-21
PGE or Benefit Plan Review Billing Tip Sheet 11-19-2018 (pdf)
2018-12-06
Payment Recovery Form (Void-Disallowance) (xlsx)
Revised 06-15-2019 2019-06-21
Residential Bed Day Billing SanWITS Screens (pdf)
Rev 05-01-2019 2019-06-10
Residential Case Management-Recovery Services SanWITS Screens (pdf)
Rev 05-22-2019 2019-06-10
SUD Aid Code Master Chart (pdf)
2019-11-27
SUD Billing Matrix (pdf)
2020-09-17
SUD ICD-10 List (xls)
2019-11-25

PC1000

PC 1000 Education Track Fee (pdf)
2019-08-29
PC 1000 Participant Handout (docx)
` 2019-08-29
PC 1000 Participant Status Report (pdf)
` 2019-08-29
PC 1000 Program Manual (pdf)
` 2019-08-29
PC 1000 Program Orientation Checklist (docx)
` 2019-08-29
PC 1000 Referral Form (pdf)
` 2019-08-29
PC 1000 SanWITS Education Track Flow (pdf)
2019-08-29
PC 1000 SanWITS Treatment Flow (pdf)
2019-08-29

Medical Director Info

5.28.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.09.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
5.14.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.23.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.03.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
7.23.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
6.25.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
7.09.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.16.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
6.11.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.30.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
5.07.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
One-Pager – Medical Director Training Requirements (pdf)
Revised 4/21/20 2020-04-30
QM Memo - Physical Exam Requirements (pdf)
2019-10-03
One-Pager - Medical Director in DMC-ODS (pdf)
2018-07-05

Recovery Residences

2020-04-20 - COVID Invoice Reporting Guidelines (pdf)
2020-09-01
One-Pager - Recovery Residences – Supplemental Funding (pdf)
Effective 01/01/2020 2020-01-13
Recovery Residence Census Revised (xlsx)
2020-09-01

Monitoring

MRR Tool FY2021 - OTP (pdf)
Revised 8/11/20 2020-09-01
Medication Monitoring Instructions (pdf)
06/20/2019 2019-09-09
Medication Monitoring McFloop Form (pdf)
06/19/2019 2019-09-09
Medication Monitoring Submission Fillable Form (pdf)
06/18/2019 2019-09-09
Medication Monitoring Tool (pdf)
06-19-2019 2019-09-09