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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 (pdf)
Revised December 2020 2020-12-23
03 - Section 1 Detail 01-14-19 (pdf)
2019-02-11
101a Instruction Client Tracking (pdf)
Revised December 2020 2020-12-23
101b Client Tracking (pdf)
Revised December 2020 2020-12-23
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 (pdf)
Revised December 2020 2020-12-23
104c-2 Adult Initial LOC Assessment Hard Copy (pdf)
Revised December 2020 2020-12-23
104c-3 Adult Initial LOC Assessment Form Fill (pdf)
Revised December 2020 2021-02-10
104d-1 Instructions Adolescent Initial Level of Care Assessment (pdf)
Revised December 2020 2020-12-23
104d-2 Adolescent Initial LOC Assessment Hard Copy (pdf)
Revised December 2020 2020-12-23
104d-3 Adolescent Initial LOC Assessment Form (pdf)
Revised December 2020 2021-02-10
104e-1 Instructions Parent Guardian Initial Level of Care Assessment (pdf)
Revised December 2020 2020-12-23
104e-2 Parent Guardian Initial LOC Assessment Hard Copy (pdf)
Revised December 2020 2020-12-23
104e-3 Parent Guardian Initial LOC Assessment Form Fill (pdf)
Revised December 2020 2020-12-23
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 (pdf)
Revised December 2020 2020-12-23
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 Handbook Practice Guidelines and Provider Directory (pdf)
2021-02-09
210a Instructions SUD Program Admission Checklist 6-27-18 (pdf)
2018-07-06
210b SUD Program Admission Checklist (pdf)
Revised December 2020 2020-12-23
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 (pdf)
Revised December 2020 2020-12-23
306b Level of Care Recommendation (pdf)
Revised December 2020 2020-12-23
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 (pdf)
Revised December 2020 2020-12-23
601b SUD Treatment Progress Note - Hard Copy (pdf)
Revised December 2020 2020-12-23
601c SUD Treatment Progress Note - Form Fill (pdf)
Revised December 2020 2020-12-23
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 Residential Weekly Progress Note - Services 12-01-2020 (pdf)
Revised December 2020 2021-01-28
603a Instructions Residential WM Daily Progress Note 10-5-18 (pdf)
2018-10-11
603b Residential WM Daily Progress Note Hard Copy 12-01-2020 (pdf)
Revised December 2020 2020-12-23
603c Residential WM Daily Progress Note Form Fill (pdf)
Revised December 2020 2020-12-23
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 (pdf)
Revised December 2020 2020-12-23
605b Other Progress Note (pdf)
Revised December 2020 2020-12-23
605c Other Progress Note - Form Fill 12-01-2020 (pdf)
Revised December 2020 2021-01-28
700 Section 7 Detail 01-15-19 (pdf)
2019-02-11
701a Instructions Discharge Summary (pdf)
Revised December 2020 2020-12-23
701b Discharge Summary - Hard Copy (pdf)
Revised December 2020 2020-12-23
701c Discharge Summary - Form Fill (pdf)
Revised December 2020 2020-12-23
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

Forms

Disposition of IT Minor Asset Supplemental (pdf)
2021-03-04
Form DPC203 - Mobile Devices (pdf)
2021-03-04
Form DPC203 - Transfer or Disposition of Minor Equipment (pdf)
2021-03-04
Serious Incident Report (docx)
2021-03-04
Serious Incident Report - Explanation (pdf)
2020-10-08
Serious Incident Report of Findings (docx)
2021-03-04
Serious Incident Report of Findings Explanation (pdf)
2020-11-05

Communications

00 - Archived List - Communications (pdf)
Updated January 2021 2021-01-12
01 - Compliance Bulletin #30 - Cloned Documentation - 11-1017 (pdf)
2011 10/17 Issued 2018-12-06
System of Care (SOC) Application - (BHS) – Contractor Information Notice (pdf)
11/23/2020 2020-11-30
Info Notice – Transitional Care Services (pdf)
Revised 10/16/2020 2020-10-26
DHCS Medi-Cal Rx Website and Pharmacy Portal Policy (pdf)
08/14/2020 2020-10-22
DHCS Medi-Cal Rx FAQ (pdf)
06/30/2020 2020-10-22
Info Notice - Medi-Cal Rx Prescriber and Pharmacy Provider Registration and Training (pdf)
10/21/2020 2020-10-22
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
Info Notice – Extension of DMC Billable Unit Production Plan.pdf
Dec 19, 2019 2019-12-23
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
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
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
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
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
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

00 - Archived List - QM Training (pdf)
March 2, 2021 2021-03-03
01 – SUD QM Annual DMC-ODS Training (pptx)
September 24, 2020 2020-10-07
02 – Program Integrity Webinar (pdf)
Revised September 2020 2020-10-06
03 - QM Memo - SUD Providers - Beneficary Rights Webinar (pdf)
Revised 06/04/2019 2019-06-05
04 - Module 1: Introduction to DMC-ODS (pdf)
Revised 5/19/20 2020-05-21
05 – Module 2 – Medical Necessity (pdf)
Revised 5/20/20 2020-11-30
06 – Module 3 – Treatment Planning for Substance Use Disorders (pdf)
Revised 5/21/20 2020-11-30
07 – Module 4: SUD Services in Residential (pdf)
Revised 5-21-20 2020-06-09
08 – Module 5: SUD Services in Outpatient (pdf)
Revised 5-22-20 2020-06-10
09 - Module 6 - Progress Notes Documentation
Revised 06/17/2020 2021-01-12
10 - Module 7 – Discharge and Care Coordination (pdf)
Revised 5/5/20 2020-05-11
11 – Module 8: Recovery Services (pdf)
Revised 4/7/20 2020-04-08
12 – Module 9: Withdrawal Management (pdf)
2020-05-28
13 – Module 10: Case Management (pdf)
2020-06-04
14 - Example SUD Treatment Progress Note - Case Management (pdf)
2018-10-26

Manuals

County of San Diego DMC-ODS Implementation Plan.pdf
County of San Diego DMC-ODS Implentation Plan Appendix.pdf
00 - Archived List - Manuals
Updated 11/2/2020 2020-11-03
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
Updated 10/26/2020 2020-11-03
DMC - ODS Provider Services Guide (Summary of Changes)
October 2020 2020-11-03
Special Terms and Conditions (pdf)
Amended 11/19/2019 2021-03-23

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
00 - Archived List - Toolbox (pdf)
Updated December 2020 2020-12-16
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)
Updated December 2020 2020-12-16
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
Opioid Treatment Program Guidelines (pdf)
10/12/2020 2020-10-20
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 06/04/2020 2020-11-25

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
00 – Archived List – Beneficiary (pdf)
February 9, 2021 2021-02-10
01 - DMC-ODS Beneficiary Packet Materials Order Form 05-09-19 (pdf)
2019-05-13
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
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
Notice_of_Adverse_Benefit_Determination_(NOABD)_Notices (pdf)
Revised 01/08/2020 2021-04-21

UTTM

For versions of the UTTM prior to September 2018, please see the “UTTM” tab on the Organizational Provider Public Documents page.
SUD Up to the Minute - March 2021 (pdf)
2021-04-12
SUD Up to the Minute - April 2021 (pdf)
2021-04-12
SUD Up to the Minute - February 2021
2021-02-12
SUD Up to the Minute - January 2021 (pdf)
2021-01-21
SUD Up to the Minute - December 2020 (pdf)
2020 2020-12-14
SUD Up to the Minute - November 2020 (pdf)
2020 2020-11-12
SUD Up to the Minute - October 2020 (pdf)
2020 2020-10-26
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

Tip Sheet – NOABD (Notice of Adverse Benefit Determination) (pdf)
Revised 04/21/2021 2021-04-23
Tip Sheet - Additional MAT - Split Dosing (pdf)
Tip Sheet - Revised 02/03/2021 2021-02-03
Tip Sheet - Delayed Admission PE for Planned Admissions (pdf)
Revised 10/28/2020 2020-12-11
Tip Sheet - SanWITS EHR Readiness (pdf)
Revised 12/11/2020 2020-12-11
Basic Computer Skills Quiz (pdf)
Revised 12/11/2020 2020-12-11
SanWITS New User Form (pdf)
User Form 2020-10-29
SanWITS User Modification or Termination Form (pdf)
User Form 2020-10-29
Tip Sheet: Transitional Care Services (TCS) Program Enrollment in SanWITS (pdf)
Tip Sheet 2020-10-29
Tip Sheet: Courtesy Dosage Program Enrollment in SanWITS (pdf)
Tip sheet 2020-10-28
Tip Sheet: Non-BHS Contracted Client Program Enrollment / CalOMS_Reporting (pdf)
Tip sheet 2020-10-28
SanWITS Billing Enhancements 20.4.5 (pdf)
Enhancements 2020-10-08
SanWITS Screen Enhancements 20.4.5 (pdf)
Enhancements 2020-10-08
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
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
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
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 - 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
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

Billing

OTP Medicare PGE Tip Sheet (pdf)
Adding Benefit Plan Enrollment for OTP Medi-Medi clients 2021-03-03
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
Claim Item Hold Reasons (pdf)
to be utilized when putting claims in hold status 2020-10-02
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 6065A Form (pdf)
Late billing Good Cause Certification 2021-01-06
DHCS 6065A Form (xlsx)
Late billing Good Cause Certification 2021-01-06
DHCS 6065B Form (pdf)
Late billing and Good Cause Certification for DRC 8 2021-01-06
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
Instructions on Completing 6065A Form
2021-01-06
Instructions on Completing 6065B Form
2021-01-06
MAT Dosing Same Day Billing Matrix (pdf)
2021-02-18
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 10/15/2020 2020-10-16
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)
Updated Aid Code Master Chart 2021-01-28
SUD Billing Matrix (pdf)
2020-09-17
SUD DMC Billing Manual (pdf)
Revised 10/20/2020 2020-10-26
SUD DMC Billing Manual Summary of Changes (pdf)
Revised 10/20/2020 2020-10-26
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

10.29.20 SUD MD Exec Summary.pdf
Uploaded 11/12/2020 2020-11-12
10.15.20 SUD MD Exec Summary.pdf
Uploaded 11/12/2020 2020-11-12
10.01.20 SUD MD Exec Summary.pdf
Uploaded 11/12/2020 2020-11-12
9.17.20 SUD MD Exec Summary.pdf
Uploaded 10/01/2020 2020-10-01
8.06.20 SUD MD Exec Summary.pdf
Uploaded 10/01/2020 2020-10-01
8.20.20 SUD MD Exec Summary.pdf
Uploaded 10/01/2020 2020-10-01
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

00 – Archived List - Recovery Residences (pdf)
Revised 10/29/2020 2020-10-30
2020-04-20 - COVID Invoice Reporting Guidelines (pdf)
2020-09-01
One-Pager Recovery Residences – Supplemental Funding (COVID) (pdf)
Effective during COVID Health Emergency 2020-10-30
Recovery Residence Census Revised (xlsx)
2020-09-01

Monitoring

Corrective Action Steps for Disallowed Services (pdf)
10/09/2020 2020-10-30
MRR Tool FY2021 - OTP (pdf)
Revised 8/11/20 2020-09-01
MRR Tool FY2021 - Outpatient (pdf)
Updated 10/07/2020 2021-03-24
MRR Tool FY2021 - Residential (pdf)
Updated 10/07/2020 2021-03-24
MRR Tool FY2021 - WM (pdf)
Updated 10/07/2020 2021-03-24
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
Self-Identified Disallowances - Tip Sheet (pdf)
Updated 10/1/2020 2020-11-09
TA Tool FY2021 - Outpatient (pdf)
Updated 10/27/2020 2021-03-24
TA Tool FY2021 - Residential (pdf)
Updated 12/07/2020 2021-03-24
TA Tool FY2021 - WM (pdf)
Updated 10/27/2020 2021-03-24

Training - SanWITS

Video Tutorials

SanWITS Assessments Training available online New
Intro to Admin Functions available online
Outpatient OTP Encounters available online. 
Residential Encounters Orientation and Practice available online

Intro to Admin Functions Orientation and Practice

Outpatient Encounters Orientation and Practice

Residential Encounters Orientation and Practice