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MHP Provider Documents

This page is utilized by BHS Provider Staff to obtain forms, manuals and reports for the electronic health record, Cerner Community Behavioral Health.

A new Cerner Community Behavior Health (CCBH) EHR Training Tips and Resources page is now available for providers and Program Managers.

For Behavioral Health Services Provider Communications and Local information on COVID-19 Please visit the County OF San Diego Webpage.Coronavirus Disease 2019 COVID-19

NOABD

NOABD Webinar available online.
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
NOABD_Delivery_System_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Authorization_Delay_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
NOABD_Timely_Access_Notice_-_SPANISH.doc
- 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
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
NOABD_Authorization_Delay_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Termination_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Modification_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ARABIC.docx
- 2018-08-07
NOABD_Modification_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_VIETNAMESE.doc
- 2018-08-07
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
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.pdf
- 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
NOABD_Timely_Access_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Termination_Notice_-_VIETNAMESE.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
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
NOABD_Delivery_System_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_FARSI.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Financial_Liability_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Termination_Notice_-_FARSI.doc
- 2018-08-07
NOABD Denial of Authorization Notice – ARABIC (doc)
- 2018-08-07
NOABD Denial of Authorization Notice – CHINESE (doc)
2023-12-01
NOABD Denial of Authorization Notice – ENGLISH (doc)
2020-06-16
NOABD Denial of Authorization Notice – FARSI (doc)
- 2018-08-07
NOABD Denial of Authorization Notice – KOREAN (doc)
2023-12-01
NOABD Denial of Authorization Notice – SOMALI (doc)
2023-12-01
NOABD Denial of Authorization Notice – SPANISH (doc)
- 2018-08-07
NOABD Denial of Authorization Notice – TAGALOG (docx)
- 2018-08-07
NOABD Denial of Authorization Notice – VIETNAMESE (doc)
- 2018-08-07
NOABD Payment Denial Notice SPANISH (docx)
2020-06-16
NOABD Table
Revised April 2024 2024-05-23
NOABD Termination Notice - SPANISH (doc)
2020-05-08
NOABD_Authorization_Delay_Notice_-_CHINESE.doc
2023-12-01
NOABD_Authorization_Delay_Notice_-_KOREAN.doc
2023-12-01
NOABD_Authorization_Delay_Notice_-_SOMALI.doc
2023-12-01
NOABD_Delivery_System_Notice_-_CHINESE.doc
2023-12-04
NOABD_Delivery_System_Notice_-_CHINESE.pdf
2023-12-04
NOABD_Delivery_System_Notice_-_KOREAN.doc
2023-12-04
NOABD_Delivery_System_Notice_-_KOREAN.pdf
2023-12-04
NOABD_Delivery_System_Notice_-_SOMALI.doc
2023-12-04
NOABD_Delivery_System_Notice_-_SOMALI.pdf
2023-12-04
NOABD_Financial_Liability_Notice_-_CHINESE.doc
2023-12-01
NOABD_Financial_Liability_Notice_-_KOREAN.doc
2023-12-01
NOABD_Financial_Liability_Notice_-_SOMALI.doc
2023-12-01
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_CHINESE.doc
2023-12-01
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_KOREAN.doc
2023-12-01
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_SOMALI.doc
2023-12-04
NOABD_Modification_Notice_-_CHINESE.doc
2023-12-04
NOABD_Modification_Notice_-_KOREAN.doc
2023-12-04
NOABD_Modification_Notice_-_SOMALI.doc
2023-12-04
NOABD_Payment_Denial_Notice_-_CHINESE.docx
2023-12-04
NOABD_Payment_Denial_Notice_-_KOREAN.docx
2023-12-04
NOABD_Payment_Denial_Notice_-_SOMALI.docx
2023-12-04
NOABD_Termination_Notice_-_CHINESE.doc
2023-12-04
NOABD_Termination_Notice_-_KOREAN.doc
2023-12-04
NOABD_Termination_Notice_-_SOMALI.doc
2023-12-04
NOABD_Timely_Access_Notice_-_CHINESE.doc
2023-12-04
NOABD_Timely_Access_Notice_-_KOREAN.doc
2023-12-04
NOABD_Timely_Access_Notice_-_SOMALI.doc
2023-12-04
NOABD_Your_Rights_Notice_-_CHINESE.doc
2023-12-04
NOABD_Your_Rights_Notice_-_CHINESE.pdf
2023-12-04
NOABD_Your_Rights_Notice_-_KOREAN.doc
2023-12-04
NOABD_Your_Rights_Notice_-_KOREAN.pdf
2023-12-04
NOABD_Your_Rights_Notice_-_SOMALI.doc
2023-12-04
NOABD_Your_Rights_Notice_-_SOMALI.pdf
2023-12-04
SanWITS NOABD
2019-10-25
SanWITS NOABD
2019-10-25

Beneficiary

The order form to request hard copies of Beneficiary Materials is available online
MHP Beneficiary Handbook_January 2024_English_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_English.pdf
2024-08-26
MHP Beneficiary Handbook Summary of Changes 12-1-23 (pdf)
Updated December 2023 2023-11-28
MHP Beneficiary Handbook_January 2024_Tagalog_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Spanish_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Vietnamese_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Somali.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Persian (Dari_Farsi)_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Chinese (Trad).pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Spanish.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Somali_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Persian (Dari_Farsi).pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Tagalog.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Chinese (Trad)_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Korean.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Vietnamese.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Arabic.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Arabic_Large Font.pdf
2024-08-26
MHP Beneficiary Handbook_January 2024_Korean_Large Font.pdf
2024-08-26
Quick Guide To MH Services-Arabic (pdf)
2024-09-05
Quick Guide To MH Services-Chinese (pdf)
2024-09-05
Quick Guide To MH Services-English (pdf)
2024-09-05
Quick Guide To MH Services-Korean (pdf)
2024-09-05
Quick Guide To MH Services-Persian (Dari_Farsi) (pdf)
2024-09-05
Quick Guide To MH Services-Somali (pdf)
2024-09-05
Quick Guide To MH Services-Spanish (pdf)
2024-09-05
Quick Guide To MH Services-Tagalog (pdf)
2024-09-05
Quick Guide To MH Services-Vietnamese (pdf)
2024-09-05
Physician Notice To Patients CA Regulation_English.pdf
2024-08-26
Physician Notice To Patients CA Regulation_Somali.pdf
2024-08-26
Physician Notice to Patients California Regulation_Arabic.pdf
2024-08-26
Physician Notice To Patients CA Regulation_Persian_(Dari_Farsi).pdf
2024-08-26
Physician Notice to Patients California Regulation_Vietnamese.pdf
2024-08-26
Physician Notice to Patients California Regulation_Chinese.pdf
2024-08-26
Physician Notice to Patients California Regulation_Korean.pdf
2024-08-26
Physician Notice to Patients California Regulation_Tagalog.pdf
2024-08-26
Physician Notice to Patients California Regulation_Spanish.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Vietnamese.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Arabic.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Persian (Dari_Farsi).pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_English.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Korean.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Chinese (Traditional).pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Somali.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Tagalog.pdf
2024-08-26
Limited_English_Proficiency_Poster_04-2023_Spanish.pdf
2024-08-26
Advance Directive - PUB325_Arabic_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Vietnamese_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Chinese_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Persian (Dari_Farsi)_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Korean_12.2016.pdf
2024-08-26
Advance Directive - PUB325_English_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Somali_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Spanish_12.2016.pdf
2024-08-26
Advance Directive - PUB325_Tagalog_12.2016.pdf
2024-08-26
Human Trafficking Notice – Arabic (pdf)
2024-08-08
Human Trafficking Notice – English (pdf)
2024-08-08
Human Trafficking Notice – Dual English - Spanish (pdf)
2024-08-08
Human Trafficking Notice – Farsi (pdf)
2024-08-08
Human Trafficking Notice – Korean (pdf)
2024-08-08
Human Trafficking Notice – Spanish (pdf)
2024-08-08
Human Trafficking Notice – Tagalog (pdf)
2024-08-08
Human Trafficking Notice – Chinese (Traditional) (pdf)
2024-08-08
Human Trafficking Notice – Vietnamese (pdf)
2024-08-08
ACL Poster - Dari (pdf)
2024-07-17
Beneficiary_Non-Discrimination_Notice_-_SOMALI.pdf
2023-11-30
NAR_Your_Rights_State_Hearing_-_KOREAN.pdf
2023-11-30
NAR_Your_Rights_State_Hearing_-_SOMALI.pdf
2023-11-30
Beneficiary_Non-Discrimination_Notice_-_KOREAN.pdf
2023-11-30
Beneficiary_Non-Discrimination_Notice_-_CHINESE.pdf
2023-11-30
NAR_Your_Rights_State_Hearing_-_CHINESE.pdf
2023-11-30
Beneficiary_Non-Discrimination_Notice_-_SOMALI.doc
2023-11-30
NAR_Your_Rights_State_Hearing_-_CHINESE.doc
2023-11-30
Beneficiary_Non-Discrimination_Notice_-_CHINESE.doc
2023-11-30
Notice_of_Grievance_Resolution_-_SOMALI.doc
2023-11-30
Beneficiary_Non-Discrimination_Notice_-_KOREAN.doc
2023-11-30
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_CHINESE.doc
2023-11-30
Notice_of_Grievance_Resolution_-_KOREAN.doc
2023-11-30
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_SOMALI.doc
2023-11-30
Notice_of_Grievance_Resolution_-_CHINESE.doc
2023-11-30
NAR_Your_Rights_State_Hearing_-_KOREAN.doc
2023-11-30
NAR_Your_Rights_State_Hearing_-_SOMALI.doc
2023-11-30
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_KOREAN.doc
2023-11-30
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_SOMALI.doc
2023-11-30
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_CHINESE.doc
2023-11-30
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_KOREAN.doc
2023-11-30
SD Grievance-Appeal POSTER Somali (pdf)
Revised 03/05/2019 2023-11-15
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Somali (docx)
2023-11-15
SD Grievance-Appeal POSTER Korean (pdf)
Revised 03/05/2019 2023-11-15
SD Grievance-Appeal POSTER Chinese (pdf)
Revised 03/05/2019 2023-11-15
SD Grievance - Appeal Brochure - Somali (pdf)
Revised 08/27/2021 2023-11-15
SD Grievance - Appeal Brochure - Korean (pdf)
Revised 08/27/2021 2023-11-15
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Chinese (docx)
2023-11-15
SD Grievance - Appeal Brochure - Chinese (pdf)
Revised 08/27/2021 2023-11-15
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Somali (docx)
2023-11-15
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Korean (docx)
2023-11-15
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Korean (docx)
2023-11-15
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Chinese (docx)
2023-11-15
NPP Acknowledgement Somali (pdf)
2023-10-17
Notice of Privacy Practices – Somali (pdf)
2023-09-15
NPP Acknowledgement Chinese (pdf)
2023-10-17
Notice of Privacy Practices - Korean (pdf)
2023-09-15
Notice of Privacy Practices – Chinese (pdf)
2023-09-15
NPP Acknowledgement Korean (pdf)
2023-10-17
NPP Acknowledgement Dari (pdf)
2023-10-17
Notice of Privacy Practice - Dari (pdf)
2023-09-15
ACL Poster - Vietnamese (pdf)
2023-11-06
ACL Poster - Traditional Chinese (pdf)
2023-11-06
ACL Poster - Tagalog (pdf)
2023-11-06
ACL Poster - Spanish (pdf)
2023-11-06
ACL Poster - Somali (pdf)
2023-11-06
ACL Poster - Korean (pdf)
2023-11-06
ACL Poster - Farsi (pdf)
2023-11-06
ACL Poster - English (pdf)
2023-11-06
ACL Poster - Dari (pdf)
2023-11-06
ACL Poster - Arabic (pdf)
2023-11-06
Open Payments Database Notice to Clients Display (docx)
Link 2023-05-01
Open Payments Database Physician Notice to Clients (docx)
Revised 01/19/2023 2023-05-01
CA Board of Psychology Consumer Statement - Korean (pdf)
2023-05-01
CA Board of Psychology Consumer Statement - Chinese (pdf)
2023-05-01
BBS Required Notice to Consumers 2022 (pdf)
2022-05-25
San Diego Provider List Translation Instructions (pdf)
2021-07-19
SD Grievance - Appeal Brochure - Vietnamese (pdf)
Revised 08/27/2021 2022-03-30
SD Grievance - Appeal Brochure - Arabic (pdf)
Revised 08/27/2021 2022-03-30
SD Grievance - Appeal Brochure - English (pdf)
Revised 08/27/2021 2022-03-30
SD Grievance - Appeal Brochure - Farsi (pdf)
Revised 08/27/2021 2022-03-30
SD Grievance - Appeal Brochure - Spanish (pdf)
Revised 08/27/2021 2022-03-30
SD Grievance - Appeal Brochure - Tagalog (pdf)
Revised 08/27/2021 2022-03-30
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 English (docx)
Revised 06/28/2018 2021-11-04
Grievance and Appeal Form – CCHEA OP Advocacy 7-1-18 Persian (Dari/Farsi) (docx)
2021-09-14
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Arabic (docx)
2021-09-14
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Tagalog (docx)
2021-08-24
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Spanish (docx)
2021-08-24
Grievance and Appeal Form – CCHEA OP Advocacy 6-28-18 Vietnamese (docx)
2021-08-24
Grievance and Appeal Form – JFS Advocacy 08-20-21 – Persian (Dari/Farsi)
2021-08-24
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Arabic (docx)
2021-08-24
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Vietnamese (docx)
2021-08-23
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Tagalog (docx)
2021-08-23
Grievance and Appeal Form – JFS Advocacy 08-20-21 - Spanish (docx)
2021-08-23
Grievance and Appeal Form – JFS Advocacy 08-20-21 - English (docx)
2021-08-23
NPP Acknowledgement Arabic (pdf)
Revised August 2021 2021-08-20
NPP Acknowledgement English (pdf)
Revised August 2021 2021-08-20
NPP Acknowledgement Farsi (pdf)
Revised August 2021 2021-08-20
NPP Acknowledgement Spanish (pdf)
Revised August 2021 2021-08-20
NPP Acknowledgement Tagalog (pdf)
Revised August 2021 2021-08-20
NPP Acknowledgement Vietnamese (pdf)
Revised August 2021 2021-08-20
CA Board of Psychology Consumer Statement-English (pdf)
2021-07-27
CA Board of Psychology Consumer Statement-Spanish (pdf)
2021-07-27
CA Board of Psychology Consumer Statement-Tagalog (pdf)
2021-07-27
CA Board of Psychology Consumer Statement-Vietnamese (pdf)
2021-07-27
MHP Beneficiary Handbook Cover in Threshold Languages (pdf)
Revised 07/10/2019 2021-07-19
SD Grievance-Appeal POSTER English LARGE FONT (pdf)
Revised 03/05/2019 2021-07-15
SD Grievance-Appeal POSTER Spanish (pdf)
Revised 03/06/2019 2021-07-15
SD Grievance-Appeal POSTER Arabic (pdf)
Revised 03/06/2019 2021-07-14
SD Grievance-Appeal POSTER English (pdf)
Revised 03/06/2019 2021-07-14
SD Grievance-Appeal POSTER Farsi (pdf)
Revised 03/06/2019 2021-07-14
SD Grievance-Appeal POSTER Tagalog (pdf)
Revised 03/06/2019 2021-07-14
SD Grievance-Appeal POSTER Vietnamese (pdf)
Revised 03/06/2019 2021-07-14
Beneficiary Non-Discrimination Notice - ENGLISH (pdf)
2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_VIETNAMESE.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_TAGALOG.docx
- 2018-08-07
Notice_of_Grievance_Resolution_-_SPANISH.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_FARSI.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_ENGLISH.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_ARABIC.doc
- 2018-08-07
Beneficiary Non-Discrimination Notice - ENGLISH (doc)
2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.docx
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_SPANISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_FARSI.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_VIETNAMESE.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ENGLISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ENGLISH.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_SPANISH.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_FARSI.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.pdf
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.docx
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_SPANISH.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_SPANISH.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_FARSI.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_FARSI.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ARABIC.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ARABIC.doc
2018-08-06
Beneficiary Problem Resolution Process (doc)
2018-06-28
Notice of Privacy Practices - Farsi (pdf)
2018-02-13
NoticeofPrivacyPractices_Vietnamese_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_Tagalog_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_Spanish_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_English_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_Arabic_12-16-14.pdf
2017-02-06

Communications
2024-09-03 BHS Info Notice - Outcome Measures for Children & Youth (pdf)
2024-09-04
2024-09-03 – BHS Info Notice – Utilization Management (UM) Updates (pdf)
2024-09-04
County Logo for Provider Use – HHSA/Live Well San Diego (Grey text)
4/24/2024 2024-04-24
County Logo for Provider Use – HHSA/Live Well San Diego (White text)
4/24/2024 2024-04-24
2024-02-06- BHS Info Notice - Prior Authorization Request Form Alignment with CalAIM Update (pdf)
2024-02-09
2023-12-28 BHS Info Notice - SMHS Documentation Reform (pdf)
2024-01-04
2023-09-12 - BHS Contractor Memo #2 TAY CANS (docx)
2023-09-14
2023-09-12 - BHS Contractor Memo Changes to Informed Consent Requirements for Psychotropic Medication (pdf)
2023-09-14
2023-06-29-BHS Contractor Memo-Single Point of Access for ACT and SBCM (pdf)
2023-08-02
MH Access Times FAQ and Tip Sheet (pdf)
06/30/2023 2023-07-11
CANS Sharing Confirmation Form Retirement (pdf)
Effective July 1, 2023 2023-06-27
2023-05-20-BHS Provider Memo-Payment Reform CPT for SMHS (pdf)
2023-06-06
2023-05-04 - BHS Contractor Memo-Open Payments Database (pdf)
2023-05-19
2023-04-20 – BHS Contractor Memo-TAY CANS (pdf)
2023-05-04
2023-05-01- BHS Contractor Memo- Open Payments Database (pdf)
Memo 2023-05-01
2023-02-22 – BHS Provider Memo – Screening and Transition Tool (docx)
2023-02-23
Revised 2023-2-8-BHS and Probation Care Coordination Directive_.pdf
2023-02-16
Day Treatment CalAIM and Contract Requirement Updates Memo 11.17.22 (docx)
2022-12-02
BHS Contractor Memo – CalAIM Documentation Reform (docx)
08/15/2022 2022-08-25
2022-06-21 – BHS Info Notice – Utilization Management (UM) Update (pdf)
2022-06-24
BHS Contractor Memo-CalAIM Documentation Reform
05/22/2022 2022-05-24
2022-02-11-BHS Contractor Memo-Medi-Cal RX Update dbc (docx)
2022-03-15
2021-11-10-BHS Contractor Memo-Medi-Cal RX 2021 (pdf)
2021-11-15
2021-06-29-BHS Information Notice-CYF Utilization Management Reinstated Effective 7.1.21 (pdf)
Effective July 1, 2021 2021-06-30
System of Care (SOC) Application - (BHS) – Contractor Information Notice (pdf)
11/23/2020 2020-11-30
Medication Assisted Treatment (MAT) Referrals (pdf)
2020-08-27
QM Memo ICD-10 7-16-20 (pdf)
2020-07-17
3/19/20 BHS Provider Notice #3- COVID 1- Quality Improvement Updates and Best Practices (pdf)
2020-03-20
QM Memo - EBP Indicator Removal for Homework & Child Family Team Meetings (docx)
Issued 02/06/2020 2020-02-07
QM MEMO - Medication Monitoring (pdf)
Issued 01/31/2020 2020-01-31
QIP Texting Presentation (pptx)
2020-01-21
CYF MEMO - Updated Ancillary SMHS Request Form (pdf)
Effective 1/1/2020 2020-01-10
CYF Memo Prior Auth for Day Services (pdf)
Effective 1-1-2020 2020-01-10
QM MEMO - CSI Diagnosis errors (pdf)
Issued 12/26/2019 2019-12-30
CYF MEMO - Utilization Management Outpatient Cycle Expansion (pdf)
Issued 12/20/2019 2019-12-30
QM Memo - DHCS Revised Telehealth Policies (docx)
Issued 12/06/2019 2019-12-09
QI - PIT MEMO - SOC Application (pdf)
2019-11-04
Optum San Diego Website MH Provider Registration Instructions (pdf)
2019-11-04
CYF MEMO – Revised UM Request Form (pdf)
Issued 09/03/2019 2019-09-06
CYF MEMO – IHBS Prior Authorization 08/16/19 (pdf)
2019-08-20
CYF Memo – TBS Prior Authorization Process (pdf)
Issued 7/29/19 2019-08-14
QM MEMO - New BHS 025 Forms (docx)
2019-04-24
QM MEMO - New Updated Discharge Form - 4.4.19 (pdf)
2019-04-12
CYF MEMO - Revised CANS Sharing Confirmation 3.26.19 (pdf)
2019-04-09
QM MEMO – PROSPECTIVE RISK ANALYSIS – 02.07.19 (docx)
2019-02-08
QM MEMO – PROSPECTIVE RISK ANALYSIS – 02.14.19 (doc)
2019-02-08
QM MEMO - Prospective Risk Analysis (docx)
2019-01-09
QM MEMO_-_New_Non-Bill_Other_Support_Service_Code_01_29_18.pdf
2018-11-29
QM MEMO - Patient_Advocacy Services for BHS - Record Requests 11 01 18 (pdf)
2018-10-31
QM MEMO - Privacy - Confidentiality Legislative Updates 10.23.18 (docx)
2018-10-24
QM MEMO_-_Specialty_Mental_Health_Service_Claiming_for_ES-HS_9_7_18.pdf
2018-10-08
Intensive_Service_Request_ISR_CYF_Memo_04-1617.pdf
2017-06-30
QM MEMO - Specialty Mental Health Service Claiming for ES-HS (pdf)
2018-09-10
QM MEMO – Billing for C-practitioners 07 02 18 (docx)
2018-07-13
QM MEMO – AOA Outpatient Utilization Management 06 29 18 (pdf)
2018-07-13
QI_PIT_MEMO_2018 6-1-18 AOA Substance Use Tracking Reporting Changes (pdf)
2018-06-14
QM MEMO - Controlled Substance - CURES Mandate (pdf)
2018-06-08
QM_MEMO_-_New_Auth_to_Use-Disclose_Multiple_Form_051513.pdf
2017-05-12
QM_MEMO_-_Client_Plan_Redesign_6-20-17.pdf
2017-06-27
QM_MEMO_-_Utilization_of_BHA_Adult_Walk_In_for_OP_Walk_In_Services_6_21_17.pdf
2017-06-27
QM_MEMO_-_New_Evidence_Based_Practice_Indicators_06_23_17.pdf
2017-06-27
QM_MEMO_-_Allowed_Services_Prior_to_Client_Plan_Completion_-_DHCS_Guidelines_6_20_17.pdf
2017-06-21
QM Memo - New Billing Indicators - Intrepreter and Language 06-08-17 (pdf)
2017-06-14
QM_MEMO_-_Day_Treatment_Interim_Folder_03_29_17.pdf
2017-03-31
QM_MEMO_-_Place_of_Service_Update_03_30_17.pdf
2017-03-31
QM_MEMO_- 42_CFR_Final_Rule_1-26-17.pdf
2017-02-02
QI_MIS_MEMO_2016_12_01_CCBH_Client_Attachments.pdf
2018-05-25
QI_MIS_MEMO_2016_10_31_CCBH_Demographic_Form_Table_Change.docx
2016-11-03
QI_MIS_MEMO_2016_05_09_CCBH_Outside_of_the_Office_Update.pdf
2016-05-11
QM_MEMO_-_Day_Tx_Program_-_Updated_Standards.5.1.16.docx
2016-05-11
QI_MIS_MEMO_2015_11_20_Saving_Reports_to_a_SpreadsheetProcess_and Policy.pdf
2015-11-30
QM_MEMO_DHP_4_14.pdf
2015-10-09
QM_MEMO_-_Reaffirming_DHCS_Day_Treatment_Standards_08_26_14.docx
2015-10-09
QM_MEMO_-_New_Interactive_Add_On_Service_Code_785_9_22_14.docx
2015-10-09
QM_MEMO_-_Documentation_Guidelines_when_EHR_Unavailable_9_04_14.docx
2015-10-09
QM_Memo_-_90_Day_Lockout_Process_Update_11_06_13.pdf
2015-10-09
QI_MIS_MEMO_2014_1_09_Notifications_in_Anasazi.pdf
2016-05-16
QM Memo - CPT Coding Changes 2013 (pdf)
2016-07-15
QM Memo - LPCC Credential Under MHP 07 24 13 (doc)
2015-10-09
QM Memo - Holder of Records 01 03 13 (pdf)
2016-07-15
CSI Requirement for MH Programs 08 27 12 (pdf)
2016-07-15

Forms
5150 Form (pdf)
Revised 09/2023 2023-11-09
72 Hour Post Discharge Log (pdf)
2017-03-23
AOB - Arabic Version (docx)
2021-11-09
AOB - Arabic Version (pdf)
2021-11-05
AOB - English Version (docx)
2023-09-06
AOB - Spanish Version (docx)
2021-11-09
AOB - Spanish Version (pdf)
2021-11-05
AOB - Tagalog Version (docx)
2021-11-09
AOB - Tagalog Version (pdf)
2021-11-05
AOB - Vietnamese Version (docx)
2021-11-09
AOB - Vietnamese Version (pdf)
2021-11-05
Access to Services Log (xlsx)
2018-06-20
BHS 025 Form and Instructions (pdf)
2024-09-16
CAPS Administrative Days Weekly Contacts Log (docx)
2024-07-22
CCBH Void and Replace Form (xlsm)
Revised 10/04/2021 2021-10-07
Case Management Six Month Review Progress Note (pdf)
2017-03-23
Case Management UR Record (pdf)
2017-03-23
Case Management URC Minutes Form (pdf)
2017-03-23
DHCS 1739 Mental Health Professional Licensing Waiver Request (pdf)
2021-03-12
DPC 203 and 204 Forms (docx)
2023-02-07
Group Service Record (rtf)
Revised 08/2020 2020-08-07
HSD Medi-Cal Quick Guide Screening Tool (docx)
2021-12-13
Individual Service Record (doc)
Revised 07/10/2024 2024-07-11
JV220(A) - Physician's Statement - Attachment (pdf)
2018-03-01
JV220(B) - Physican's Request to Continue Medication - Attachment (pdf)
2018-03-01
MAA Service Record (pdf)
2017-08-24
Med Mon McFloop Form (docx)
Revised 01/17/2020 2020-01-31
Med Monitoring Submission Form - Adult (xlsx)
Revised 12/08/2023 2023-12-19
Med Monitoring Submission Form - Childrens (xlsx)
Revised 12/08/2023 2023-12-19
Med Monitoring Tool AOA (docx)
Revised 04/10/2024 2024-04-11
Med Monitoring Tool CYF (docx)
Revised 04/10/2024 2024-04-11
Medi-Cal Administrative Activities (MAA) Procedures
2017-08-24
Medication Disposal Log (pdf)
2021-06-03
Mental Health Professional Licensing Waiver Request (pdf)
DHCS 1739 Revised 11/2021 2022-01-10
NVRA Voter Preferences Form-Arabic (pdf)
2021-03-12
NVRA Voter Preferences Form-English (pdf)
2021-03-12
NVRA Voter Preferences Form-Spanish (pdf)
2021-03-12
NVRA Voter Preferences Form-Tagalog (pdf)
2021-03-12
NVRA Voter Preferences Form-Vietnamese (pdf)
2021-03-12
NVRA_Voter_Preference_Form_Farsi.pdf
2017-09-14
New MRR Hybrid Chart and Program Compliance CHECKLIST (docx)
Revised 02/12/2021 2021-02-18
QIP Follow up Form FY 20-21 (docx)
2020-08-07
Reestablishment Recommendation Form (doc)
2021-03-12
Request for Verification of Veterans Eligibility (pdf)
2017-03-23
START TCC and URC Record (pdf)
2017-03-23
START URC Minutes Form (pdf)
2017-03-23
Service Authorization Request (pdf)
2021-03-12
Transition of Care Tool for Medi-Cal Mental Health Services (pdf)
2023-02-28
Transition of Care Tool for Medi-Cal Mental Health Services - Explanation Form (docx)
Revised 01/01/2024 2024-01-16
Written Translation Service Authorization Form (pdf)
2021-03-12

Manuals

OPOH
01 - Cover Sheet Org Provider Manual (pdf)
Revised 09/09/2024 2024-09-11
02 - Table of Contents Org Prov Op Handbook (pdf)
Revised 04/10/2024 2024-04-10
03 - OPOH - Customer Service Mission (pdf)
Revised 09/09/2024 2024-09-11
04 – OPOH – Section A – Systems of Care (pdf)
Revised 08/02/2024 2024-09-11
05 - OPOH - Section B - Compliance Confidentiality (pdf)
Revised 08/30/2024 2024-09-11
06 - OPOH - Section C - Accessing Services (pdf)
Revised 08/24/2024 2024-09-09
07 - OPOH- Section D - Providing Specialty Mental Health Services (pdf)
Revised 08/26/2024 2024-09-09
08 - OPOH - Section E - Integration with Physical Healthcare (pdf)
Revised 02/29/2024 2024-09-11
09 - OPOH - Section F - Beneficiary Rights Grievance Appeals (pdf)
Revised 09/10/24 2024-09-11
10 - OPOH - Section G - Quality Improvement (pdf)
Revised 07/18/2024 2024-07-23
11 – OPOH – Section H – Cultural Competency (pdf)
Revised 05/07/2024 2024-05-09
12 – OPOH – Section I – Management Info System (pdf)
Revised 12/12/2023 2023-12-20
13 - OPOH - Section J - Provider Contracting (pdf)
Revised 08/29/24 2024-09-11
14 - OPOH - Section K - Provider Issue Resolution (pdf)
Revised 02/19/2020 2020-03-02
15 – OPOH – Section L – Practice Guidelines (pdf)
Revision 08/23/2024 2024-09-09
16- OPOH- Section M - Staff Qualifications (pdf)
Revised 09/06/2024 2024-09-11
17 - OPOH - Section N - Data Requirements (pdf)
Revised 08/01/2024 2024-09-11
18 - OPOH - Section O - Training (pdf)
Revised 09/09/2024 2024-09-11
19 - OPOH - Section P - Mental Health Services Act (pdf)
Revised 09/10/2024 2024-09-11
20 – OPOH – Section Q – Payment Schedule and Budget Guidelines (pdf)
Revised 10/05/2021 2021-10-06
21 - OPOH - Section R - Quick_Reference (pdf)
2019-05-22
030 - OPOH - Appendix C - A.C.2 - AMHS - Walk-in Clinics Hours Contacts (pdf)
2019-07-18
031 - OPOH - Appendix C - A.C.3 - Transition Age Youth Referral Form (pdf)
Revised 04/15/2014 2016-07-13
032 - OPOH - Appendix C - A.C.4 - Transtion Age Youth Referral Plan 4-15-14 (pdf)
Revised 04/15/2014 2016-07-13
058 - 00 - OPOH - Appendix E - A.E.3 - Plan Partner Identification for Pharmacies (pdf)
2016-07-13
105 - OPOH - Appendix K - A.K.1 - Formal Complaint by Provider Form (pdf)
2016-07-13
106 - OPOH - Appendix K - A.K.2 - Formal Response To Complaint Form (pdf)
2016-07-13
107 - OPOH - Appendix K - A.K.3 - Formal Appeal by Provider Form (pdf)
2016-07-13
108 - OPOH - Appendix K - A.K.4 - Formal Appeal Response Form (pdf)
2016-07-13
109 - 01 - OPOH - Appendix L - A.L.1 - Monitoring Psychotropic Medications (pdf)
Revised 05/20/2024 2024-05-22

Resources

References
EPSDT_TBS_Brochure_English.pdf
2016-07-15
EPSDT_TBS_Brochure_Spanish.pdf
2016-07-15
State_Plan_Amendment_SPA_12-025.pdf
2015-10-09
ICD_10_and_DAS_Tip_Sheet_09.2015.docx
2016-07-15
037_-_OPOH_-_Appendix_D_-_A.D.03_-_California_State_Penal_Institutions_List_.pdf
2017-03-23
QI_UPDATES_-_Annual_7_11_17 FINAL.pdf
2017-07-13
State_Health_Information_Guidance_-_December_2017.pdf
2017-12-18
Program_Provider_Numbers_List.pdf
2018-02-15
Travel_Time_Guidelines_Final_2-01-18.pdf
2018-02-15
Setting the Face Sheet to Display Instructions (doc)
2016-07-15
CCBH_-_CP_Folder_and_PN_TIP_SHEET-updated_6_16_17.pdf
2017-06-27
CCBH_-_Quick_Click_Guide_REVIEW_-_REVISE-updated_6_16_17.pdf
2017-06-27
CCBH_CP_Quick_Click_Guide-updated_6_16_17.pdf
2017-06-27
Client_Management_Payment_Report_V3.pdf
2016-07-15
PWB Report Template Instructions (pdf)
2016-05-16
Payment Appilication Claims Report Instructions (pdf)
2016-05-16
Service_Date_Verification_Report.pdf
2016-05-16
BHS Quality Improvement 8th Annual Mental Health Providers Knowledge Forum - Presentation handout.pdf
2021-09-07
BHS Quality Improvement 8th Annual Mental Health Providers Knowledge Forum - Question-Answer Sheet.pdf
2021-09-07
3rd Party Suspense Report Instructions (ppt)
2019-04-10
7th Annual Mental Health Forum 9.22.20 - QA (docx)
2020-10-08
Active Parolee Clients Report Instructions (docx)
2020-10-01
BHS Information Notice-Utilizing CANS Strengths in Therapy
03/09/2021 2021-03-10
Billing Lockout Settings and Non-Reimbursable/Reimbursable Activities (pdf)
Revised 06/26/2023 2023-06-27
Billing SMHS for Sibling Sets Guidelines (docx)
2024-05-09
Billing for Medication Services (docx)
11/29/2023 2023-12-04
CCBH Report Uses for Program Integrity (pdf)
2019-10-07
CSI Correction Guide – Full Version (pdf)
2021-01-29
CSI Correction Guide – Most Frequent Errors (pdf)
2021-01-29
Case Management versus Collateral (docx)
2021-03-15
Client Categories Maintenance (pdf)
2018-06-29
Client Categories – Parolee Tip Sheet (docx)
2020-07-31
Clinical Standard for Assessments (doc)
2018-06-15
Clinical Standards For Client Plans (pdf)
Updated 6/28/2019 2019-07-01
Crisis Intervention SC 70 Guideline (pdf)
2020-09-09
Denial Report Instructions (ppt)
2019-09-16
Diagnosis Practice Guidelines (pdf)
Updated 01/24/2022 2022-01-25
HOW Service Model Data Collection Flow (pdf)
2021-03-12
Housing Quality Checklist (docx)
2023-07-11
Interactive Add-On for Admin Staff (pdf)
2023-07-11
Interactive Add-On for Clinical Staff (pdf)
2023-07-11
Interpreter Add-On for Admin Staff (pdf)
2023-07-11
Interpreter Add-On for Clinical Staff (pdf)
2023-07-11
List of Controlled Substance 08.20.20 (pdf)
2020-09-01
MAA Procedures (pdf)
2021-03-12
MAA Service Record (pdf)
2021-03-12
MH CPT Crosswalk (xlsb)
Revised 02/26/2024 2024-02-29
MIS-25 Program Listing Report (xlsx)
2024-08-13
Medi-Cal Certification-Recertification Tool (xls)
FY 22-23 2022-04-07
Medi-Cal Rx Provider Registration and Training FAQs (pdf)
2021-12-16
Medi-Cal Rx Provider Training Checklist (pdf)
Revised 11/04/2021 2021-12-16
Medi-Cal Rx UAC Registration Quick Start Guide (pdf)
2021-12-16
Medical Necessity CalAIM Updates (docx)
Active 01/01/2022 2021-12-15
Medication Monitoring Process Flow Chart for Org Providers (pdf)
2021-04-27
Mental Health Professional Licensure Waiver (pdf)
2021-01-06
Mobile Crisis Billing Tip Sheet (docx)
2024-08-07
Mobile Crisis Response Documentation Requirements (docx)
2024-08-07
New Contractor Orientation Resources (pdf)
Revised 04/02/2024 2024-07-10
Progress Note Checklist Table (pdf)
Checklist 2020-03-10
QAPR Program Compliance Attestation FY24-25 (docx)
2024-08-30
QAPR Tool – FY 24-25 – 8.27.24 (xlsx)
2024-08-30
QI UPDATES MHP 7th ANNUAL 09.22.20 (pdf)
2020-10-08
QUALITY IMPROVEMENT KNOWLEDGE FORUM Presentation (pdf)
presented July 12, 2019 2019-07-18
Quality Improvement Annual Forum 2018 - Powerpoint (pptx)
07-25-2018 Presentation 2018-07-26
Reasons for Recoupment SMHS FY 24-25 (pdf)
2024-08-30
SOC Application - QIP Presentation (pdf)
Presented 10/22/19 2019-10-23
San Diego County BHS Abbreviations List (pdf)
Revised 03/23/2022 2023-07-31
Short-Doyle Medi-Cal (SDMC) Aid Code Master Chart (pdf)
Updated Aid Code Master Chart 2021-01-28
Telehealth Reminder Slides_QIP-July 2020 (pdf)
PowerPoint Presentation 10/22/2018 2020-07-29
Tip Sheet for Billable Services (docx)
Revised 08/22/2023 2023-09-01
Transferring Clients Between Different Program Sites rev. 12.28.23 (docx)
2024-01-04
Trauma-Informed Care Code of Conduct (pdf)
2019-06-17
Treatment Team Documentation Standards (pdf)
2018-09-11
Utilizing CANS Strengths in Therapy (pdf)
March 2021 2021-03-10
Who to Contact List (pdf)
2021-04-20

UCRM
ADVANCE DIRECTIVE ADVISEMENT (doc)
2018-05-25
ADVANCE DIRECTIVE ADVISEMENT EXPLANATION (docx)
2018-05-25
ANCILLARY SMHS REQUEST - EXPLANATION (pdf)
2020-01-10
ANCILLARY SMHS REQUEST - FORM FILL (docx)
2020-01-10
AOA OUTPATIENT UM EXPLANATION FORM 1.31.19.docx
Revised 01/31/2019 2019-02-08
AOA OUTPATIENT UM FORM FILL (docx)
2019-02-08
AOA PATIENT MEDICATION AGREEMENT – EXPLANATION (docx)
2018-07-26
AUTHORIZATION TO USE OR DISCLOSE PHI (docx)
2023-08-21
AUTHORIZATION TO USE OR DISCLOSE PHI EXPLANATION (docx)
2018-02-09
CARE PLAN EXPLANATION (docx)
Revised 09/06/24 2024-09-11
CLINICAL CLIENT PROBLEMS - PROBLEM LIST (pdf)
2024-09-11
COORDINATION OF CARE WITH PCP FORM (docx)
2024-09-05
COORDINATION OF CARE WITH PCP FORM EXPLANATION (docx)
2024-09-05
CSI STANDALONE FACE SHEET (pdf)
2024-09-11
CSSRS LIFETIME - ADULT (pdf)
2024-09-11
CSSRS LIFETIME - CHILD (pdf)
2024-09-11
Child and Family Team CFT Meeting Note Form Fill 07.07.23 (docx)
2023-07-11
Consent for Services (docx)
Revised 01/31/2023 2023-02-08
Coordinated-Care-Consent COSD rev 9.6.24 (docx)
2024-09-09
DIAGNOSIS (pdf)
2024-09-11
DISCHARGE SUMMARY (pdf)
2024-09-11
ECBI EXPLANATION (docx)
2018-05-25
Explanation for Eligibility Form (pdf)
2017-10-25
FACE SHEET – DEMOGRAPHICS (pdf)
09/2024 2024-09-11
FSP AGREEMENT (pdf)
07/30/24 2024-09-11
IHBS AUTHORIZATION REQUEST – EXPLANATION (docx)
Revised 02/01/2024 2024-02-19
IHBS PRIOR AUTHORIZATION REQUEST FORM FILL (pdf)
Revised 02/01/2024 2024-02-12
IHBS PRIOR AUTHORIZATION WEB BASED SUBMISSION FORM - INSTRUCTIONS (docx)
Revised 02/07/2024 2024-02-12
IMR ADULT OUTCOMES EXPLANATION (docx)
2018-02-13
IMR ASSESSMENT (pdf)
2021-02-02
IMR CLINICIAN ASSESSMENT FORM (pdf)
2021-02-02
INFORMED CONSENT PSYCHOTROPIC MEDICATION ENGLISH (docx)
2021-03-05
INFORMED CONSENT PSYCHOTROPIC MEDS EXPLANATION (docx)
2023-05-23
IOP and PHP PRIOR AUTHORIZATION DAY SERVICES REQUEST EXPLANATION SHEET (docx)
2024-01-04
IOP and PHP PRIOR AUTHORIZATION DAY SERVICES REQUEST FORM FILL (docx)
Revised 01/02/2024 2024-01-04
LOCUS ADULT OUTCOMES EXPLANATION (docx)
2018-02-13
LOCUS Instrument Version 20 (pdf)
Adult Version 20, December 2016 2019-06-28
MORS ADULT OUTCOME EXPLANATION (docx)
2018-02-13
MORS ADULT OUTCOME MEASURE (docx)
2018-05-25
PRIOR AUTHORIZATION DAY SERVICES REQUEST (docx)
Revised 04/01/2022 2022-03-25
PRIOR AUTHORIZATION DAY SERVICES REQUEST – EXPLANATION (docx)
2022-06-13
PSC-35 EXPLANATION (docx)
09/2024 2024-09-11
RELEASE OF INFORMATION CHILD 04-24A-P (dot)
2017-02-17
REQUEST FOR ACCESS COPY OF PHI (doc)
2017-02-17
RISK ASSESSMENT (pdf)
2024-09-11
RISK ASSESSMENT EXPLANATION (docx)
2024-09-11
Recovery Markers Questionnaire Form 093009 (pdf)
2020-07-14
SAFETY PLAN (pdf)
2024-09-11
SAFETY PLAN EXPLANATION (docx)
2024-09-11
SATS-R ADULT OUTCOME EXPLANATION (docx)
2018-02-13
SATS-R FORM 2 (doc)
2017-03-02
SERVICE NOTE (pdf)
2024-09-11
SHIFT SUMMARY (pdf)
2024-09-11
TADT (pdf)
2024-09-11
UM Request Explanation Sheet (pdf)
Revised 09/03/24 2024-09-04
UM Request Form (docx)
Revised 09/03/24 2024-09-04
YOUTH TRANSITION SELF EVALUATION EXPLANATION (docx)
2021-08-20
Youth Transition Self Evaluation Formfill (docx)
2020-06-18

UTTM
QM…Up to the Minute – August 2024 (pdf)
2025 2024-08-15
QM…Up to the Minute – July 2024 (pdf)
2025 2024-07-12
QM…Up to the Minute – September 2024 (pdf)
2025 2024-09-16
QM…Up to the Minute – June 2024 (pdf)
2024 2024-06-14
QM…Up to the Minute – May 2024 (pdf)
2024 2024-05-09
QM…Up to the Minute – April 2024 (pdf)
2024 2024-04-12
QM...Up to the Minute - March 2024 (pdf)
2024 2024-03-18
QM…Up to the Minute - February 2024 (pdf)
2024 2024-02-08
QM…Up to the Minute - January 2024 (pdf)
2024 2024-01-16
QM…Up to the Minute - December 2023 (pdf)
2023 2023-12-19
QM…Up to the Minute - November 2023 (pdf)
2023 2023-11-17
QM…Up to the Minute - October 2023 (pdf)
2023 2023-10-16
QM...Up to the Minute - September 2023 (pdf)
2023 2023-09-18
QM...Up to the Minute - August 2023 (pdf)
2023 2023-08-11
QM...Up to the Minute - July 2023 (pdf)
2023 2023-07-15
QM...Up to the Minute - June 2023 (pdf)
2023 2023-06-09
QM...Up to the Minute - May 2023 (pdf)
2023 2023-05-12
QM...Up to the Minute - April 2023 (pdf)
2023 2023-04-14
QM...Up to the Minute - March 2023 (pdf)
2023 2023-03-14
QM...Up to the Minute - February 2023 (pdf)
2023 2023-02-10
QM...Up to the Minute - January 2023 (pdf)
2023 2023-01-13
QM...Up to the Minute -December 2022 (pdf)
2022 2022-12-13
QM...Up to the Minute -November 2022 (pdf)
2022 2022-11-14
QM...Up to the Minute - October 2022 (pdf)
2022 2022-10-18
QM...Up to the Minute - September 2022 (pdf)
2022 2022-10-18
QM...Up to the Minute - August 2022 (pdf
2022 2022-08-12
QM...Up to the Minute - July 2022 (pdf)
2022 2022-07-20
QI...Up to the Minute - FY 2021 -2022 (pdf)
2021 - 2022 2022-09-20
QM...Up to the Minute - April 2022 (pdf)
2022 2022-04-15
QM...Up to the Minute - August 2021 (pdf)
2021 2021-08-12
QM...Up to the Minute - December 2021 (pdf)
2021 2021-12-13
QM...Up to the Minute - February 2022 (pdf)
2022 2022-02-10
QM...Up to the Minute - January 2022 (pdf)
2022 2022-01-25
QM...Up to the Minute - July 2021 (pdf)
2021 2021-07-08
QM...Up to the Minute - June 2022 (pdf)
2022 2022-06-10
QM...Up to the Minute - March 2022 (pdf)
2022 2022-03-30
QM...Up to the Minute - May 2022 (pdf)
2022 2022-05-13
QM...Up to the Minute - November 2021 (pdf)
2021 2021-11-12
QM...Up to the Minute - October 2021 (pdf)
2021 2021-10-14
QM...Up to the Minute -September 2021 (pdf)
2021 2021-09-10

Training

CCBH Training page - Tips and Resources

Training Classes Video Tutorials and Resource Packets

Admin Data Entry
Service Entry Training
Scheduler Orientation and Practice Exercises
Assessments Orientation and Practice Exercises
Crisis House Assessments Orientation and Practice Exercises
Client Plans and Progress Notes Orientation and Practice Exercises
Progress Notes Orientation and Practice Exercises
Doctor's Homepage Orientation and Practice Exercises
View Only Assessments
TBS Client Plans and Progress Notes Orientation and Practice Exercises
CCBH Login Process Tutorial

Progress Note Correction Resources

Progress Notes Correction Video Tutorials
Billing Correction Tutorials

Other Training Resources and Tip SheetS

Reports Demonstration

Covid-19 Dashboard Tutorial available online (new)
Claim It Anyway (CIA) Webinar available online (new)
NOABD Webinar available online
Service Indicators Webinar available online

PWB
Explanation_for_Eligibility_form-10-25-17.pdf
2017-11-07
Eligibility-for-PWB-and-Enhanced-Services-Form-Fill-09.20.2017.docx
2017-11-07
Child and Family Team CFT Meeting Note Form Fill 07.07.23 (docx)
2023-07-11
Intensive Care Coordination (ICC) (pdf)
2018-06-21
Intensive Care Coordination (ICC) Note Explanation (pdf)
2018-10-30
Progress Report to Child Welfare Services Explanation (pdf)
Updated 04/01/2023 2023-04-21
Progress Report to Child Welfare Services Form Fill (pdf)
Revised 04/01/2023 2023-04-21

STRTP
AB1299 STRTP Admission Report (docx)
Revised 03/24/2022 2022-06-03
AB1299 STRTP Admission Report Explanation Form (pdf)
Revised 03/24/2022 2022-06-03
BHS Contractor Memo – Tracking Out of County Medi-Cal Beneficiaries in CCBH – Revised AB1299 STRTP Admission Report (pdf)
Memo Date 03/04/2022 2022-06-03
BHS Contractor Memo-Revised AB1299 STRTP Admission Report (pdf)
Memo Date : 03/02/20121 2021-03-02
BHS Contractor Memo-Revised STRTP Forms - Effective November 2020 (pdf)
Memo - 11/20/2020 2020-11-25
CYF MEMO – STRTP Release of Forms 08/16/19 (pdf)
2019-08-20
Daily Progress Note (docx)
2023-01-05
Daily Progress Note Explanation Sheet (docx)
2023-01-05
Optional AB1299 STRTP Tracking Tool (xlsx)
Revised 03/02/2021 2021-03-02
STRTP ADMISSION STATEMENT FORM FILL (docx)
2020-11-25
STRTP ADMISSION STATEMENT – EXPLANATION (pdf)
Revised 06/24/2019 2020-11-25
STRTP DISCHARGE SUMMARY FORM FILL (docm)
2023-11-08
STRTP DISCHARGE SUMMARY FORM FILL (docx)
2023-11-17
STRTP DISCHARGE SUMMARY – EXPLANATION (pdf)
Revised 07/12/2019 2020-11-25
STRTP Hybrid Matrix (docx)
Revised 12/10/2020 2020-12-11
STRTP MEDICATION NOT PRESCRIBED PROGRESS NOTE SC11 (docx)
2020-11-25
STRTP Medication Flow Chart (pdf)
Uploaded 07-05-2019 2019-07-05
STRTP PRIOR AUTHORIZATION DAY SERVICES REQUEST (docx)
Revised 04/01/2022 2022-03-25
STRTP PRIOR AUTHORIZATION DAY SERVICES REQUEST - EXPLANATION (docx)
2022-06-10
STRTP TRANSITION DETERMINATION PLAN FORMFILL (docx)
Revised 09/02/2021 2021-09-07
STRTP Transition Determination Plan Explanation Form (docx)
Revised 09/02/2021 2021-09-07
STRTP UM Request Form (docx)
Revised 11/01/2022 2022-11-17
STRTP Utilization Management Request Explanation Form (pdf)
Revised 11/01/2022 2022-11-17
Transition Determination Plan Signature Page (docx)
Revised 09/02/2021 2021-09-07

TFC
ANNUAL TFC PARENT EVALUATION FORM FILL (docx)
2020-11-25
ANNUAL TFC PARENT EVALUATION – EXPLANATION (pdf)
2020-11-25
ANNUAL TFC PARENT SELF -EVALUATION FORM FILL (docx)
2020-11-25
ANNUAL TFC PARENT SELF-EVALUATION FORM – EXPLANATION (pdf)
2020-11-25
BHS Contractor Memo-TFC Forms Effective December 2020 (pdf)
Memo - 11/23/2020 2020-11-25
TFC ANNUAL PARENT AGREEMENT AND CERTIFICATION FORM FILL (docx)
2020-11-25
TFC CLINICAL DOCUMENTATION TIP SHEET (pdf)
09/2024 2024-09-16
TFC DAILY PROGRESS NOTE - EXPLANATION (pdf)
Revised 03/01/2023 2023-03-03
TFC DAILY PROGRESS NOTE FORMFILL (doc)
Revised 03/01/2023 2023-03-03
TFC PARENT DOCUMENTATION TIP SHEET (pdf)
2020-11-25
TFC PRIOR AUTHORIZATION REQUEST (docx)
Revised 02/01/2024 2024-02-19
TFC PRIOR AUTHORIZATION REQUEST - EXPLANATION (docx)
Revised 02/01/2024 2024-02-12

TBS
BHA - TBS EXPLANATION (docx)
Revised 02/02/2022 2022-02-04
BHA TBS Form Fill (doc)
Revised 02/02/2022 2022-02-07
Brochure - English & Spanish 2.2023
2023-02-16
TBS CLIENT PLAN FORM FILL (docx)
2018-05-25
TBS CLIENT PLAN SIGNATURE PAGE (docx)
2018-05-25
TBS One Pager for Providers (pdf)
2023-02-15
TBS Overview PPT (pdf)
2023-02-15
TBS PRIOR AUTHORIZATION REQUEST AND REFERRAL FORM FILL (docx)
Revised 04/01/2022 2022-03-25
TBS PRIOR AUTHORIZATION REQUEST AND REFERRAL – EXPLANATION SHEET (docx)
Revised 04/01/2022 2022-03-25
TBS PROGRESS NOTE FORM_FILL (docx)
2020-08-07
TBS TREATMENT PLAN EXPLANATION (docx)
2018-02-13

Billing Unit/Finance

Billing Unit Manuals

Billing Unit Resources

Billing Unit Forms

SmartCare

System of Care (SOC) Information and Resources

EHR Implementation FAQ 08-20-24 (pdf)

SOC Resources | Training
CCBH Training Documentation Guide June 2024 (pdf)
Guidance for navigating use of CCBH after training ceases and before SmarCare go-live, including downtime forms 2024-07-01
CalMHSA Required Training by Role Grid (pdf)
SmartCare Trainings by Staff Role – Updated 7/27/2024 2024-07-29
Guide – Admin Service Entry v1
2024-09-03
Guide – CSU v3 (pdf)
2024-09-03
Guide – Data and Bill Only v1
2024-08-30
Guide – LTC.SNF Data and Bill With Res Board (pdf)
2024-09-03
Guide – Residential Workflow Change (pdf)
2024-09-04
Guide – Residential v2 (pdf)
2024-09-03
SmartCare EHR Training summary (July 2024) (pdf)
Summary of SmartCare required and optional training details 2024-07-15
SmartCare LMS Log In Tip Sheet FINAL 7.11 (pdf)
SmartCare LMS Training Log In Tip Sheet 2024-07-15
SmartCare Training Registration Tip Sheet (pdf)
SmartCare Training Registration Tip Sheet for Supplementary Training Enrollment 2024-07-30

SOC Resources | Requirements and Functionality
Administrative Service Entry (pdf)
This workflow shows the steps for service entry where a progress note will be completed outside of the SmartCare EHR. This process also works through the steps for billing for Add-On procedure codes. 2024-08-30
Authorizations for Services Process (pdf)
This resource is to provide direction on the process for submitting Authorization requests to Optum 2024-08-30
CCBH to SC Preliminary Reports Crosswalk 2024-08-23 (pdf)
An incomplete crosswalk of CCBH reports to potential SmartCare reports. Additional work is underway to provide more detailed information on report availability (Updated 8/23/2024) 2024-08-30
EPCS Invite Guide 082124 update (pdf)
High level information to support prescriber setup for electronic processing of controlled substances (EPCS) using the soft token app VIP Access by Symantec (Updated 8/21/24) 2024-08-21
EPCS Onboarding Guide (pdf)
High level information to support prescriber setup for electronic prescribing of controlled substances (EPCS) using the soft token app VIP Access by Symantec. 2024-08-16
NOABD Log FY 24-25 (xlsx)
Updated tracking log for completion by programs and submission to QA. 2024-08-27
Quick Start FAQs SmartCare CalMHSA Rx (pdf)
Quick Start instructions and FAQs for launching and using CalMHSA Rx (e-prescribing) 2024-08-30
SmartCare CANS PSC July 2024 (pdf)
Summarizes entry of CANS and PSC into SmartCare instead of mHOMS 2024-07-17
SmartCare Client Insurance Entry July2024 (pdf)
Guidance for providers who currently enter insurance information into CCBH or SanWITS – insurance entry will cease at go-live. See the accompanying form: SmartCare Client Insurance Plan Request 2024-07-17
SmartCare Client Insurance Plan Request_updated 08.30.2024 (docx)
SmartCare Client Insurance Plan Request Form for clients with healthcare coverage besides Medi-Cal. See accompanying guidance: SmartCare Client Insurance Entry July2024 2024-09-12
SmartCare Data Migration Resource (pdf)
Updated timelines and guidance to providers about the planned data migration from SanWITS and CCBH to SmartCare. (Updated 8/26/24) 2024-08-27
SmartCare Document Scanning (pdf)
An additional driver is needed for efficient document scanning in SmartCare. This resource provides instructions for document scanning with or without this driver. 2024-09-10
SmartCare DrFirst (CalMHSA Rx) Guidance 2024-08-29 (pdf)
Includes important updates and information related to E-prescribing, including instructions for tokens, identity verification, medication migration, and training. (Updated 8/29/24) 2024-08-30
SmartCare Hardware_Software and Network Requirements - March 2024 update (pdf)
SmartCare hardware, software, and network requirements for customer workstations 2024-03-18
SmartCare NOABD Procedure for MH and SUD (pdf)
An update for SUD providers on the NOABD process, with no change to process for MH providers. 2024-08-27
SmartCare Non Billable Codes 7-29-24 (pdf)
A table highlighting all nonbillable actions that can be entered into the SmartCare system. 2024-08-15
SmartCare Program Crosswalk (xlsx)
Excel-based crosswalk of programs from CCBH or SanWITS to SmartCare. 2024-08-27
SmartCare Service Code Crosswalk (xlsx)
This crosswalk contains both MH & SUD service codes that will be available in SmartCare, cross-walking them with current legacy system codes. Revised 09/12/24. 2024-09-16
SmartCare Then and Now EHR Transition Guidance 8-12-24 (pdf)
Guidance informing users how to navigate new options in SmartCare while ensuring regulations and requirements are met. 2024-08-15
SmartCare UCRM Changes – 8-13-24 (pdf)
SmartCare has fewer forms than CCBH; BHS will sunset numerous forms. This resource outlines planned changes. 2024-08-15
SmartCare Walk-in Workflow (pdf)
Workflow for all providers with a walk-in clinic. 2024-08-27
SmartCare Workflow for Mental Health and Substance Use Disorder 8-12-24 (pdf)
High Level workflows in SmartCare including tips and naming of various aspects of workflows 2024-08-15

SOC Resources | Go-Live Preparation
Site Lead Checklist and Troubleshooting Guide (pdf)
Checklist and Troubleshooting Guide to aid Site Lead support of programs for go-live 2024-08-30
SmartCare Help Desk Flyer Post Go-Live (pdf)
SmartCare Help Desk Flyer Post Go-Live SmartCare Help Desk Flyer Post Go-Live SmartCare help desk support instructions + SmartCare workflow and documentation resources Remove the Help Desk Flyer – 08-20-24 and replace with this updated version. 2024-09-09
SmartCare Site Lead Kick Off Meeting PPT 07.17.2024
2024-07-22
SmartCare Site Lead Selection Guidance (pdf)
Guidance for the selection of site leads at each facility 2024-06-10

SmartCare Information Notices
2024-04-04 SmartCare information notice (pdf)
Overview of SmartCare implementation to date 2024-04-08
2024-07-19 BHS Provider Memo – EHR Update (pdf)
07/19/2024 2024-07-24
2024-08-01 BHS Provider Memo – EHR Update (pdf)
08/01/2024 2024-08-12
2024-08-23 BHS Info Notice (pdf)
8/23/2024 2024-08-26
2024-08-28 BHS SmartCare Information Notice (pdf)
This information notice summarizes recently shared communication and guidance related to the SmartCare go-live on Sunday, September 1, 2024. 2024-08-30

Town Hall PowerPoint Presentations
2023-11-17 EHR Town Hall (pdf)
November 2023 Town Hall 2023-11-28
2024-01-30 EHR Town Hall (pdf)
January 2024 Town Hall 2024-02-01
2024-02-20 EHR Town Hall (pdf)
February 2024 Town Hall 2024-02-21
2024-03-19 EHR Town Hall
March 2024 Town Hall 2024-03-21
2024-04-30 EHR Town Hall (pdf)
April 2024 Town Hall 2024-04-30
2024-05-21 EHR Town Hall (pdf)
May 2024 Town Hall 2024-05-21
2024-06-18 EHR Town Hall (pdf)
June 2024 Town Hall 2024-06-18
2024-07-29 SmartCare Town Hall (pdf)
July 2024 Town Hall 2024-07-30
2024-08-13 SmartCare Town Hall (pdf)
August 13, 2024 Town Hall 2024-08-15
2024-08-27 SmartCare Town Hall (pdf)
August 27, 2024 Town Hall 2024-08-29

Serious Incident Reporting
BHS SIR FAQ and Tip Sheet (pdf)
Updated 07/24/2023 2024-02-29
BHS SIROF FAQ and Tip Sheet (pdf)
Updated 07/24/2023 2024-02-29
BHS Serious Incident Report of Findings (docx)
Updated 06/30/2023 2024-02-29
Serious Incident Report (docx)
Updated 07/24/2023 2024-02-29
Serious Incident Root Cause Analysis Worksheet (doc)
Revised 09/10/24 2024-09-11