• 1_Instructions_and_FAQs_Credentialing_and_Contracting (pdf)
• 2 Credentialing Criteria (pdf)
• 3 Credentialing Application Instructions (pdf)
• 4_Provider_Clinical_Application_Medi-Cal (pdf)
• 5 FFS Specialty Addition App (docx)
• 6 Medi-Cal Documentation Training (pdf)
• 7 Form W-9 (pdf)

New Provider Requirements

• Optum San Diego Website Provider Registration Instructions (pdf)

• CANS Instructions and Process (pdf)
• CANS User Guide (pdf)
• CANS-PSC Completion Tip Sheet with link to Tools (pdf)
• CANS_PCS Telehealth Memo 4.2.20
• California Pediatric Symptom Checklist (pdf)
• FFS Memo CANS PSC and Optum Demographic Forms 11.4.24 (pdf)
• Full-CANS (pdf)
• Full-CANS Form Fill.pdf

• LMFT/LCSW/LPCC FFS Medi-Cal Billing Codes (pdf)
• MD/DO FFS Medi-Cal Billing Codes (pdf)
• PHD/PsyD FFS Medi-Cal Billing Codes (pdf)
• PNP/PA FFS Medi-Cal Billing Codes (pdf)

2022 Communication/Updates

• CPT Codes 90846 and 99201 REMOVED from Fee Schedule (pdf)
• CalAIM Changes to Medical Necessity, Diagnosis & Reasons for Recoupment (pdf)
• Documentation Requirement Updates - Psychotherapy (pdf)
• Documentation Requirement Updates – Medication Services (pdf)
• False Claims Act Requirement 2022 (pdf)
• HSD Pharmacy Benefit Quick Guide (pdf)
• Mandatory E-Prescriptions (pdf)

2021 Communication/Updates

• Request to Complete Short Questionnaire (pdf)

Archived Communication/Updates

• Microsoft Word - Optum Response to Presumptive Transfer Inquiries in SD -3.9.18
• Mild-Moderate-Severe FAQs (pdf)
• Outpatient Authorizations for Continuing Services during COVID-19 (pdf)
• Telephone Telehealth Approved Notification (pdf)
• Therapeutic Behavioral Services Prior Authorization Request & Referral Process (pdf)

• BHS SIR FAQ and Tip Sheet (pdf)
• BHS SIROF FAQ and Tip sheet (pdf)
• BHS Serious Incident Report (docx)
• BHS Serious Incident Report of Findings (docx)
• Timely Access to Care (pdf)

Compliance Trainings

• Federal and State False Claims Act - Contractor Roles and Responsibilities (pdf)
• Privacy and Security Training (pdf)

• FFS Operations Handbook (pdf)
• Inpatient Operations Manual (pdf)

• OPTUMIST Newsletter Fall 2024 (pdf)
• OPTUMIST Newsletter Spring 2024 (pdf)
• OPTUMIST Newsletter Summer 2024 (pdf)
• OPTUMIST Newsletter Winter 2024 (pdf)

Provider Services

• Provider_Update_Form_Group_to_PP.pdf
• Change From a Group to a Private Practice (pdf)
• Change of Address, Phone, Demographics Form (pdf)

Telehealth

• Standards of Practice for Telehealth
• Telehealth Attestation (pdf)

• Inpatient Note Example (pdf)
• Inpatient Professional Service Documentation Guide (pdf)
• Inpatient Review Tool (pdf)

• Optum Adult MQA Tool (pdf)
• Optum Child MQA Tool (pdf)

• 2023 Pre-Credentialing Site Review Tool (pdf)
• 2023 Site Review Tool (pdf)
• 2023 Treatment Record Review Tool (pdf)
• Beneficiary Material Request Form (pdf)
• Initial Client Checklist (pdf)
• Reasons for Recoupment (pdf)
• Record Keeping and Medical Record Requirements (pdf)

• Ancillary Specialty Mental Health Services Request (docx)
• Demographic Form Fill (pdf)
• ECT Authorization Request Form (pdf)
• Interpreter Services Request Form (pdf)
• MFT Eligibility Verification Form (pdf)
• Outpatient Authorization Request - Medication Services (docx)
• Outpatient Authorization Request - Medication Services Form Fill (pdf)
• Outpatient Authorization Request - Psychotherapy (docx)
• Outpatient Authorization Request - Psychotherapy Form Fill (pdf)
• Psych Testing Request Form (docx)

Documentation Best Practices

• Best Practice Series - Assessment (pdf)
• Best Practice Series - Treatment Plan (pdf)
• Best Practices Series- Intake Paperwork and Informer Consent (pdf)
• Best Practices Series- Record Keeping Requirements (pdf)

• Inpatient Auth Request Fax Cover Sheet (pdf)
• Optum Notification - Hospitals Prospective Review - Effective 04/03/2023 (pdf)
• San Diego Inpatient Concurrent Review Authorization Process (pdf)

• Optum Inpatient Auth Request Fax Cover Sheet and Pamphlet (OOC) (pdf)