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.

SOC and NACT Tools and Resources

COVID-19

Coronavirus Disease 2019
COVID-19 FAQs for BHS Providers
How to Manage Your Mental Health and Cope During COVID-19
CA Health Alert Network (CAHAN)

BHS Provider Notice

Notice # 1 - BHS Provider Notice - COVID-19 (pdf)
Notice #2 - BHS Provider Notice - COVID-19 - Guidance and Best Practices (pdf)
Notice #3 - BHS Provider Notice - COVID-19 - Quality Improvement Updates and Best Practices (pdf)
Notice #4 - BHS Provider Notice - COVID-19 - Financial Practices and Contract Management Updates (pdf)

Reporting Guidance

Other COVID-19 Resources and Updates

NOABD

NOABD Webinar available online (new)


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_Denial_Notice_-_VIETNAMESE.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_Denial_Notice_-_FARSI.doc	-	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_Denial_Notice_-_SPANISH.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_Denial_Notice_-_TAGALOG.docx	-	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_Denial_Notice_-_ARABIC.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 Notice ENGLISH (doc)		2020-06-16
NOABD Log (xlsx)		2020-04-30
NOABD Payment Denial Notice SPANISH (docx)		2020-06-16
NOABD Table (pdf)	Revised 01/08/2020	2020-01-08
NOABD Termination Notice - SPANISH (doc)		2020-05-08
SanWITS NOABD
SanWITS NOABD

Beneficiary


Beneficiary Non-Discrimination Notice - ENGLISH (pdf)		2018-08-07
Beneficiary Materials MHP Order Form (docx)		2019-10-04
Full Guide Arabic 2019 (pdf)	Arabic	2019-07-10
Full Guide Farsi 2019 (pdf)	Farsi	2019-07-10
Quick Guide to MH Services - English (pdf)		2019-05-16
Quick Guide to MH Services - Spanish (pdf)		2019-05-16
Quick Guide to MH Services - Tagalog (pdf)		2019-05-16
Quick Guide to MH Services - Farsi (pdf)		2019-05-16
Quick Guide to MH Services - Vietnamese (pdf)		2019-05-16
Quick Guide to MH Services - Arabic (pdf)		2019-05-16
Full Guide Vietnamese 2019 (pdf)	MHP_Beneficiary_Handbook_Rv_5_01_2019_VIETNAMESE.pdf	2019-05-13
Full Guide Tagalog 2019 (pdf)	MHP_Beneficiary_Handbook_Rv_5_01_2019_TAGALOG.pdf	2019-05-13
Full Guide English 2019 (pdf)	MHP_Beneficiary_Handbook_1_24_2019.pdf	2019-02-01
Full Guide Spanish 2019 (pdf)	MHP-Beneficiary-Handbook-SPANISH 5 01 2019.pdf	2019-05-09
Limited_English_Proficiency_Poster_Vietnamese_07-10-18.pdf	-	2019-02-07
Limited_English_Proficiency_Poster_Tagalog_07-10-18_.pdf	-	2019-02-07
Limited_English_Proficiency_Poster_Spanish_07-10-18.pdf	-	2019-02-07
Limited_English_Proficiency_Poster_Farsi_07-10-18.pdf	-	2019-02-07
Limited_English_Proficiency_Poster_English_07-10-18.pdf	-	2019-02-07
Limited_English_Proficiency_Poster_Arabic_07-10-18.pdf	-	2019-02-07
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
Grievance-Appeal Brochure Farsi (pdf)		2018-02-28
Advance_Directive_Farsi.pdf		2018-02-28
NPP Acknowledgement - Farsi (pdf)		2018-02-13
Notice of Privacy Practices - Farsi (pdf)		2018-02-13
SD Grievance-Appeal POSTER Vietnamese (pdf)		2018-01-19
SD Grievance-Appeal POSTER Tagalog (pdf)		2018-01-19
SD Grievance-Appeal POSTER Spanish (pdf)		2018-01-19
SD Grievance-Appeal POSTER Farsi (pdf)		2018-01-19
SD Grievance-Appeal POSTER English (pdf)		2018-01-19
SD Grievance-Appeal POSTER English LARGE FONT (pdf)		2018-01-19
SD Grievance-Appeal POSTER Arabic (pdf)		2018-01-19
Grievance_and_Appeal_Form_-_JFS_Advocacy_12-20-17_FARSI.docx		2017-12-22
Grievance_and_Appeal_Form_-_CCHEA_Advocacy_12_20_17_FARSI.docx		2017-12-22
Grievance-Appeal Brochure Arabic (pdf)		2017-11-27
Grievance-Appeal Brochure English (pdf)		2017-11-27
Grievance-Appeal Brochure Farsi (pdf)		2017-11-27
Grievance-Appeal Brochure Spanish (pdf)		2017-11-27
Grievance-Appeal Brochure Tagalog (pdf)		2017-11-27
Grievance-Appeal Brochure Vietnamese (pdf)		2017-11-27
055__-_OPOH_-_Appendix_D_-_A.D.20_-TBS_Brochure_English_2015.pdf		2017-03-23
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
NPP_Acknowledgement_Vietnamese_2016.docx		2016-07-13
NPP_Acknowledgement_Tagalog_2016.docx		2016-07-13
NPP_Acknowledgement_Spanish_2016.docx		2016-07-13
NPP_Acknowledgement_English_2016.docx		2016-07-13
NPP_Acknowledgement_Arabic_2016.docx		2016-07-13
Grievance_and_Appeal_Form_--CCHEA_OP_Advocacy_1_15_16_TAG.docx		2016-04-01
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16.docx		2016-07-13
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16_ES.docx		2016-07-13
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16_AR.docx		2016-07-13
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16_Viet.docx		2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16_AR.docx		2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16_Viet.docx		2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16_ES.docx		2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16.docx		2016-07-13
Recovery_Brochure_Spanish_09-11rev.pdf		2016-07-13
Recovery_Brochure_English_8-5-13.pdf		2016-07-13
Physician_Notice_To_Patients_California_Regulation.pdf		2016-07-13
Advance_Directive_Vietnamese.pdf		2016-07-13
Advance_Directive_Tagalog.pdf		2016-07-13
Advance_Directive_Spanish.pdf		2015-10-09
Advance_Directive_English.pdf		2015-10-09
Advance_Directive_Arabic.pdf		2016-07-13

Communications


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
ASJ Memo 8-5-2020 (docx)		2020-08-05
ASJ Tip Sheet 8-5-2020 (docx)		2020-08-05
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 - NOABD Logs (pdf)	Issued 01/31/2020	2020-01-31
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
CSI Correction Guide (pdf)	Revised 12/16/2019	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 MIS MEMO CCBH Access to Services Journal (pdf)		2018-06-15
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
FAQ_-_Request_for_Servcies_Log_-_Access_Time_Report_-_9-30-14_.pdf		2016-07-15
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)		2018-06-20
72 Hour Post Discharge Log (pdf)		2017-03-23
Access to Services Log (xlsx)		2018-06-20
BHS Serious Incident Report (docx)		2020-10-08
BHS Serious Incident Report Explanation (pdf)		2020-10-08
BHS Serious Incident Report Findings (docx)		2020-10-08
BHS Serious Incident Report of Findings Explanation (pdf)		2020-11-05
BHS-025 Form A (docx)	Client Information - Revised 3/2019	2019-04-22
BHS-025 Form A and B Tip Sheet (docx)	Client Information - Revised 4/2019	2019-05-02
BHS-025 Form B (docx)	Client Information - Revised 3/2019	2019-04-22
CCBH Void Replace Reasons Form (xlsm)	Revised 10/28/2020	2020-10-29
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
DPC 203 Contractor (xlsx)		2018-09-21
DPC 203 Fillable (pdf)		2019-06-03
DPC 203 Mobile Devices (xls)		2019-06-03
DPC 203 Mobile Devices SUPPLEMENTAL 2017 (xls)		2018-06-20
DPC 203 Salvage and Disposal Flowcharts (pdf)		2019-06-03
Group Service Record (rtf)	Revised 08/2020	2020-08-07
Individual Service Record (doc)		2020-08-07
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 01/17/2020	2020-01-31
Med Monitoring Submission Form – Children’s (xlsx)	Revised 01/17/2020	2020-01-31
Med Monitoring Tool AOA (docx)	Revised 01/17/2020	2020-01-31
Med Monitoring Tool CYF (docx)	Revised 01/17/2020	2020-01-31
Medi-Cal Administrative Activities (MAA) Procedures		2017-08-24
Medication Monitoring Submission Form – Children (xlsx)		2018-07-26
NVRA_Voter_Preference_Form_Farsi.pdf		2017-09-14
New MRR Hybrid Chart and Program Compliance CHECKLIST (docx)		2020-10-05
QIP Follow up Form FY 20-21 (docx)		2020-08-07
Request for Verification of Veterans Eligibility (pdf)		2017-03-23
SERIOUS INCIDENT ROOT CAUSE ANALYSIS WORKSHEET (doc)	Revised 07/31/2012	2020-01-29
START TCC and URC Record (pdf)		2017-03-23
START URC Minutes Form (pdf)		2017-03-23

Manuals

OPOH

OPOH - Organizational Providers Operation Handbook (pdf)


01 - Cover Sheet Org Provider Manual (pdf )		2018-09-20
02 - Table of Contents Org Prov Op Handbook (pdf)	Revised 12/21/2020	2020-12-22
03 - OPOH - Customer Service Mission (pdf)	Revised 04/08/2020	2020-04-09
04 - OPOH - Section A - Systems of Care (pdf)	Updated 10/23/2019	2019-11-07
05 - OPOH - Section B - Compliance Confidentiality (pdf )	Updated 07/09/2019	2019-07-18
06 - OPOH - Section C - Accessing Services (pdf)	Revised 03/25/2020	2020-04-09
07 - OPOH - Section D - Providing Specialty Mental Health Services (pdf)	Revised 11/05/2020	2020-11-10
08 - OPOH - Section E - Integration With Physical Healthcare (pdf)		2019-06-25
09 - OPOH - Section F - Beneficiary Rights, Grievance and Appeals (pdf)	Revised 07/30/2020	2020-08-13
10 - OPOH - Section G - Quality Improvement (pdf)	Revised 12/02/2020	2020-12-03
11 - OPOH - Section H - Cultural Competency (pdf)	Revised 06/16/2020	2020-06-29
12 - OPOH - Section I Management Info System (pdf)	Revised 02/21/2020	2020-03-02
13 - OPOH - Section J - Provider Contracting (pdf)	Revised 02/25/2020	2020-03-02
14 - OPOH - Section K - Provider Issue Resolution (pdf)	Revised 02/19/2020	2020-03-02
15 - OPOH - Section L - Practice Guidelines (pdf)	Revised 12/21/2020	2020-12-22
16 - OPOH - Section M - Staff Qualifications (pdf)	Revised 08/21/2020	2020-09-10
17 - OPOH - Section N - Data Requirements (pdf)	Revised 02/21/2020	2020-03-02
18 - OPOH - Section O - Training (pdf)	Updated 10/23/2019	2019-11-07
19 - OPOH - Section P - Mental Health Services Act (pdf)	Updated 10/23/2019	2019-11-07
20 - OPOH - Section Q - Payment Schedule and Budget Guidelines for Cost Reimbursement Contract Only (pdf)		2019-06-06
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
033 - OPOH - Appendix C- A.C.5 - Reestablishment Recommendation Form (pdf)		2016-07-13
033-1 - OPOH - Appendix C - A C 7 - Written Translation Service Authorization Form.pdf		2016-07-13
033-2 - OPOH - Appendix C - A C 8 - Service Authorization Request Form (pdf)		2016-07-13
056 - OPOH - Appendix E - A.E.1 - FINAL Coordination of Care Form - English (pdf)		2016-07-13
057 - OPOH - Appendix E - A.E.2 – HSD Plan Partner Card (pdf)		2020-02-20
058 - 00 - OPOH - Appendix E - A.E.3 - Plan Partner Identification for Pharmacies (pdf)		2016-07-13
058 - 01 - OPOH - Appendix E - A.E.4 - FINAL Coordination of Care Form - Arabic (pdf)		2016-07-13
058 - 02 - OPOH - Appendix E - A.E.5 - FINAL Coordination of Care Form Spanish (pdf)		2016-07-13
058 - 03 - OPOH - Appendix E - A.E.6 - Coordination of Care Form - Tagalog (pdf)		2016-07-13
058 -04 - OPOH - Appendix E - A.E.7 - FINAL Coordination of Care_Form Viet (pdf)		2016-07-13
088 - OPOH - Appendix G - A.G.11 - SERIOUS INCIDENT ROOT CAUSE ANALYSIS WORKSHEET (pdf)		2016-07-13
089 - OPOH - Appendix G - A.G.12 - RCA WORKSHEET Sample (pdf)		2016-07-13
092 - OPOH - Appendix G - A.G.15 - Perpetual Inventory Medication Log (pdf)		2016-07-13
093 - 1 - OPOH - Appendix G - A.G.17 - New Program Orientation (pdf)		2016-07-13
093 - 1 - OPOH - Appendix G - A.G.17 - New Program Orientation (pdf)		2016-08-16
093 - 2 - OPOH - Appendix G - A.G.18 - NVRA Voter Preference_Form - Arabic (pdf)		2016-07-13
093 - 3 - OPOH - Appendix G - A.G.19 - NVRA Voter Preference_Form - English (pdf)		2016-07-13
093 - 4 - OPOH - Appendix G - A.G.20 - NVRA Voter Preference_Form - Spanish (pdf)		2016-07-13
093 - 5 - OPOH - Appendix G - A.G.21 - NVRA Voter Preference_Form - Tagalog (pdf)		2016-07-13
093 - 6 - OPOH - Appendix G - A.G.22 - NVRA Voter Preference Form - Vietnamese (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 Psychtropic Medications (pdf)	7-16-12	2016-07-13
111 - OPOH - Appendix M - A.M.1 - License Waiver Form (pdf)	Revised 06/15/2010	2016-07-13
112 - OPOH - Appendix N - Data Requirements (pdf)		2016-07-13
113 - OPOH - Appendix N - A.N.1 - MAA Procedures (pdf)		2016-07-13
114 - OPOH - Appendix N - A.N.2 Service Record (pdf)		2016-07-13
118 - OPOH - Appendix R - Quick Reference Guide (pdf)		2016-07-13
Appendix A - A.A.3 - HOW Service Model Data Collection Flow (pdf)	Added 08/28/2019	2019-08-28
Appendix C - A.C.10 - Reestablishment Recommendation Form (doc)		2016-11-29

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
County_Webinar_ICD-10-CM_QandA_Final_9-11-15.docx		2016-07-15
ICD_10_and_DAS_Tip_Sheet_09.2015.docx		2016-07-15
Diagnosis_Practice_Guidelines_Rv_03_01_16.pdf		2016-03-15
Abbreviation List_-_BHS_Version_Final_11_30_16.docx		2016-11-30
036_-_OPOH_-_Appendix_D_-_A.D.02_-_Medical_Necessity_Criteria_for_MHP__-_Rev_7-14-09_.pdf		2017-03-23
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
FAQs from CPT Changes 2013 Webinar (pdf)		2016-07-15
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
CPT_Changes_2013_Presentation.pdf		2015-10-09
CPT_Codes_New_2013.pdf		2015-10-09
CPT_2013_Coding_Changes_FAQ.doc		2016-07-15
EM 101 - CPT Coding Changes - 2013 (pdf)		2015-10-09
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
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
Appendix III – Service Code Approved Use Summaries (pdf)		2019-03-21
BILLING LOCKOUT SETTINGS AND NON-REIMBURSABLE / REIMBURSABLE ACTIVITIES (pdf)		2018-08-10
CCBH Report Uses for Program Integrity (pdf)		2019-10-07
CCBH Void Replace Form (xlsm)	Revised 08/11/2020	2020-08-12
CYF Brief Treatment Model (docx)		2020-10-30
Case Management or Collateral Tip Sheet (docx)		2020-11-17
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
EM 102 CPT Coding Changes - 2013 (pdf)		2015-10-09
ICD-10 Crosswalk version 2.4 (xlsx)		2020-07-17
ICD-10 Included Diagnosis for SMHS 20-21 (xls)		2020-07-17
List of Controlled Substance 08.20.20 (pdf)		2020-09-01
MIS-25 Program Listing Report (xlsx)	Updated 08/2020	2020-08-12
MRR TOOL FY 20-21 (xlsx)	Revised 08/17/2020	2020-12-09
Medi-Cal Certification Recertification Tool (xls)		2020-05-05
Mental Health Professional Licensure Waiver (pdf)		2021-01-06
New Contractor Orientation Resources (docx)	Revised 06/22/2020	2020-06-23
Progress Note Checklist Table (pdf)	Checklist	2020-03-10
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 FY 2018-19 (pdf)		2019-01-22
SOC Application - QIP Presentation (pdf)	Presented 10/22/19	2019-10-23
Telehealth Reminder Slides_QIP-July 2020 (pdf)	PowerPoint Presentation 10/22/2018	2020-07-29
Tip Sheet For Billable Services (docx)		2019-06-26
Transferring Clients Between Different Program Sites (docx)		2020-08-25
Trauma-Informed Care Code of Conduct (pdf)		2019-06-17
Treatment Team Documentation Standards (pdf)		2018-09-11
Who to Contact List (pdf)		2020-09-30

UCRM


RMQ QUESTIONNAIRE FORM (pdf)	Version 12/2020	2020-12-22
IMR CLINICIAN ASSESSMENT FORM (pdf)	Version 12/2020	2020-12-22
BHA – ADULT PAPER FORM INSTRUCTIONS (docx)		2020-12-22
BHA – CHILDREN PAPER FORM INSTRUCTIONS (docx)		2020-12-22
BHA – ESU PAPER FORM INSTRUCTIONS (doc)		2020-12-22
DEMOGRAPHIC FORM FILL (docx)		2020-12-22
CASE MANAGEMENT PROGRESS NOTE FORM FILL (docx)	Revised 12/08/2020	2020-12-09
CANS EXPLANATION (pdf)		2020-11-12
CLIENT PLAN FORMFILL		2020-11-03
Prospective Risk Analysis (PRA) Explanation (docx)	Revised 10/30/2020	2020-10-30
TFC Prior Authorization Request Explanation (docx)		2020-10-15
TFC Prior Authorization Request Final (docx)		2020-10-15
TFC DAILY PROGRESS NOTE FORMFILL (doc)		2020-10-06
NURSING NOTE FORM FILL (docx)		2020-09-17
WRAPAROUND PROGRESS NOTE FORM FILL (doc)		2020-08-10
Medication Progress Note SC28 (docx)		2020-08-07
WALK IN ASSESSMENT PROGRESS NOTE FORM FILL (doc)		2020-08-07
TBS PROGRESS NOTE FORM FILL (docx)		2020-08-07
INDIVIDUAL PSYCHOTHERAPY PROGRESS NOTE FORM FILL (doc)		2020-08-07
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATIONENGLISH.docx		2020-08-05
Recovery Markers Questionnaire Form 093009 (pdf)		2020-07-14
PROSPECTIVE RISK ANALYSIS (PRA) FORM FILL (docx)		2020-07-02
Youth Transition Self Evaluation Formfill (docx)		2020-06-18
COLLATERAL PROGRESS NOTE FORM FILL (doc)		2020-08-10
Initial Screening PERT Form Fill (docx)	Revised 04/01/2020	2020-04-15
PSC- Youth Spanish 6 2018 Interactive (pdf)		2020-03-26
PSC- Parent Spanish 6 2018 Interactive (pdf)		2020-03-26
10 2018 PSC - Parent interactive (pdf)	Revised 3/2020	2020-03-26
10 2018 PSC - Youth Interactive (pdf)	Revised 3/2020	2020-03-26
PSC-Parent (Arabic)_6_2018_interactive (pdf)		2020-03-25
PSC-Parent (Farsi)_6_2018_interactive (pdf)		2020-03-25
PSC-Parent (TG)_6_2018_interactive (pdf)		2020-03-25
PSC-Youth (Arabic)_6_2018_interactive (pdf)		2020-03-25
PSC-Parent (VI)_6_2018_interactive (pdf)		2020-03-25
PSC-Youth (Farsi)_6_2018_interactive (pdf)		2020-03-25
PSC-Youth (TG)_6_2018_interactive (pdf)		2020-03-25
PSC-Youth (VI)_6_2018_interactive (pdf)		2020-03-25
Service Indicator Table Key (docx)		2020-03-18
NEVER BILLABLE PROGRESS NOTE FORM FILL (doc)		2020-03-18
OTHER PROGRESS NOTE FORM FILL (doc)		2020-08-07
DAY TREATMENT WEEKLY SUMMARY INSTRUCTIONS (docx)		2020-01-22
DAY TREATMENT WEEKLY SUMMARY (doc)		2020-01-22
PRIOR AUTHORIZATION DAY SERVICES REQUEST - EXPLANATION (pdf)		2020-01-10
ANCILLARY SMHS REQUEST - EXPLANATION (pdf)		2020-01-10
ANCILLARY SMHS REQUEST - FORM FILL (docx)		2020-01-10
PRIOR AUTHORIZATION DAY SERVICES REQUEST - FORM FILL (docx)		2020-01-10
UM Request Form (docx)	Revised 01/01/2020	2019-12-30
UM Request Explanation (pdf)	Revised 01/01/2020	2019-12-30
Psychiatric Assessment EHR Explanation (docx)		2019-12-12
BHA - CHILDREN JFS STAT FORM FILL (docx)		2019-10-16
TBS PRIOR AUTHORIZATION REQUEST AND REFERRAL FORM FILL (docx)		2019-08-14
TBS PRIOR AUTHORIZATION REQUEST AND REFERRAL – EXPLANATION (pdf)		2019-08-14
IHBS PRIOR AUTHORIZATION REQUEST FORM FILL (docx)		2019-08-20
IHBS PRIOR AUTHORIZATION REQUEST – EXPLANATION (pdf)		2019-08-20
MY SAFETY PLAN FORM FILL SPANISH (docx)	Revised 09/12/2019	2019-09-13
BHA - CHILDREN FORM FILL (docx)		2020-07-02
BHA - ADULT FORM FILL (doc)		2020-07-02
BHA - EXPLANATION (docx)		2019-08-08
AUTHORIZATION TO USE OR DISCLOSE PHI FARSI (pdf)	Uploaded 07-23-2019	2019-07-23
Medication Progress Note SC27 (docx)		2020-08-07
Medication Progress Note SC26 (docx)		2020-08-07
Medication Progress Note SC25 (docx)		2020-08-07
Medication Progress Note SC24 (docx)		2020-08-07
DISCHARGE SUMMARY PAPER FORM INSTRUCTIONS (doc)	Uploaded 07-05-2019	2019-07-05
MEDICATION PROGRESS NOTE SC28 (docx)	Uploaded 07-05-2019	2019-07-05
CLIENT PLAN SIGNATURE PAGE (docx)		2019-07-03
Locus Instrument Version 20 (pdf)		2019-06-28
DISCHARGE SUMMARY FORM FILL (docm)		2019-04-15
CANS SHARING CONFIRMATION FORM FILL (docx)		2019-04-15
SD – CANS Explanation Rv 3.11.19 (pdf)		2019-04-10
PSC – 35 Explanation Rv 3.4.19 (pdf)		2019-04-10
CANS Family Letter - Spanish (pdf)		2019-04-10
CANS Family Letter - Tagalog (pdf)		2019-04-10
CANS Family Letter - Arabic (pdf)		2019-04-10
CANS Family Letter - Vietnamese (pdf)		2019-04-10
CANS Family Letter - Farsi (pdf)		2019-04-10
CANS Sharing Confirmation page - Client Plan (pdf)		2019-04-09
CANS Sharing Confirmation - Explanation Sheet (pdf)		2019-04-09
CANS Family Letter (pdf)		2019-03-29
AOA OUTPATIENT UM EXPLANTION FORM (docx)		2019-02-08
AOA OUTPATIENT UM FORM FILL (docx)		2019-02-08
BHA - ESU FORM FILL (doc)		2020-07-02
BHA - START FORM FILL (doc)		2020-07-02
BHA – ADULT WALK IN FORM FILL (doc)		2019-02-08
HIGH RISK ASSESSMENT EXPLANATION (docx)		2019-02-08
PROSPECTIVE RISK ANALYSIS (PRA) EXPLANATION (docx)		2019-02-08
Youth Transition Self-Evaluation Explanation (docx)	Revised 07/31/2020	2020-07-31
CLIENT ASSIGNMENT FORM (doc)		2018-08-14
AOA PATIENT MEDICATION AGREEMENT – EXPLANATION (docx)		2018-07-26
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATIONS_SPANISH.docx		2020-08-05
INFORMED CONSENT PSYCHOTROPIC MEDICATION - ENGLISH (docx)		2018-07-26
INFORMED CONSENT PSYCHOTROPIC MEDS EXPLANATION (docx)		2018-07-26
WRAPAROUND_PROGRESS_NOTE_FORM_FILL.doc		2018-07-24
MEDS MANAGEMENT LONG NOTE FORM FILL (doc)		2020-08-07
INDIVIDUAL REHAB PROGRESS NOTE FORM FILL (doc)		2020-08-07
GROUP REHAB PROGRESS NOTE FORM FILL (doc)		2020-08-07
GROUP PSYCHOTHERAPY PROGRESS NOTE FORM FILL (doc)		2020-08-07
FAMILY REHAB PROGRESS NOTE FORM FILL (doc)		2020-08-10
FAMILY PSYCHOTHERAPY PROGRESS NOTE FORM FILL (doc)		2020-08-10
ESU NURSING NOTE FORM FILL (docx)		2020-08-17
AOA_PATIENT_MEDICATION_AGREEMENT_-_SPANISH.DOCX		2018-07-11
AOA Patient Medication Agreement English (pdf)		2018-06-08
CLIENT_PLAN_-_CHILDREN_EXPLANATION.docx		2018-02-13
CLIENT_PLAN_-_ADULT_EXPLANATION.docx		2018-02-13
PSYCHIATRIC_ASSESSMENT_FORMFILL.doc		2018-02-13
AIMS_FORMFILL.doc		2018-02-13
PRROGRESS_NOTES_EXPLANATION.docx		2018-02-13
WEEKLY_SUMMARY_EXPLANATION.docx		2018-02-13
TBS_TREATMENT_PLAN_EXPLANATION.docx		2018-02-13
SATS-R_ADULT_OUTCOME_EXPLANATION.docx		2018-02-13
MORS_ADULT_OUTCOME_EXPLANATION.docx		2018-02-13
LOCUS_ADULT_OUTCOMES_EXPLANATION.docx		2018-02-13
IMR_ADULT_OUTCOMES_EXPLANATION.docx		2018-02-13
SAFETY_ALERTS_FORMFILL.doc		2018-02-13
INITIAL_SCREENING_FORMFILL.doc		2018-02-13
INITIAL_SCREENING_ESU_FORMFILL.doc		2018-02-13
DIAGNOSIS_FORM.docx		2018-02-13
BHA_-_TBS_EXPLANATION.docx		2018-02-13
BHA_-_ESU_EXPLANATION.docx		2018-02-13
DISCHARGE_SUMMARY_EXPLANATION.docx		2018-02-13
DIAGNOSIS_FORM_EXPLANATION.docx		2018-02-13
AUTHORIZATION_TO_USE_OR_DISCLOSE_PHI_EXPLANATION.docx		2018-02-09
TIERS_EMOTIONAL_BEHAVIORAL_PSYCHIATRIC.docx		2018-02-09
INITIAL_SCREENING_PERT_PAPER_FORM_INSTRUCTIONS.doc		2017-11-28
Explanation_for_Eligibility_form_10-25-17.pdf		2017-10-25
MY_SAFETY_PLAN_FORM_FILL_FARSI.docx		2017-09-14
MY_SAFETY_PLAN_FARSI.pdf		2017-09-14
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_FORM_FILL_FARSI.docx		2017-09-14
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_FARSI.pdf		2017-09-14
CONSENT_FOR_SERVICES_FORM_FILL_FARSI.docx		2018-05-25
CONSENT_FOR_SERVICES_FARSI.pdf		2017-09-14
CONSENT_FOR_SERVICES_VIETNAMESE.docx		2017-08-07
CONSENT_FOR_SERVICES_TAGALOG.docx		2017-08-07
CONSENT_FOR_SERVICES_SPANISH.docx		2017-08-07
CONSENT FOR SERVICES ARABIC (docx)		2017-08-07
BHA_-_TBS_FORMFILL.doc		2017-06-14
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_ARABIC.docx		2017-04-04
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_TAGALOG.docx		2017-04-04
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_VIETNAMESE.docx		2017-04-04
BHA_-_0-5_FORMFILL.docx		2017-03-29
BHA_-_DEC_FORM_FILL.docx		2017-03-28
TIERS_TRAUMA.docx		2018-05-25
TIERS_TABLE_EXPLANATION.docx		2018-05-25
TIERS_STRESS.docx		2018-05-25
TIERS_SPIRITUAL.docx		2018-05-25
TIERS_SOCIAL_FUNCTIONING.docx		2018-05-25
TIERS_POTENTIAL_FOR_HARM.docx		2018-05-25
TIERS_PHYSICAL_HEALTH_PROBLEMS.docx		2018-05-25
TIERS_NEUROLOGICAL_BRAIN_IMPAIRMENT.docx		2018-05-25
TIERS_NEGLECT_ABUSE.docx		2018-05-25
TIERS_MEANINGFUL_ROLE.docx		2018-05-25
TIERS_LEGAL.docx		2018-05-25
TIERS_LACK_OF_PHYSICAL_HEALTH_CARE.docx		2018-05-25
TIERS_INTIMATE_RELATIONSHIPS.docx		2018-05-25
TIERS_IDENTITY_ISSUES.docx		2018-05-25
TIERS_FINANCIAL.docx		2018-05-25
TIERS_FAMILY_STRESS.docx		2018-05-25
TIERS_EDUCATION.docx		2018-05-25
TIERS_BASIC_NEEDS.docx		2018-05-25
TIERS_ABUSE_ADDICTION.docx		2018-05-25
TBS_CLIENT_PLAN_SIGNATURE_PAGE.docx		2018-05-25
TBS_CLIENT_PLAN_FORM_FILL.docx		2018-05-25
STRENGTHS_TABLE.docx		2018-05-25
SATS-R_FORM_2.doc		2017-03-02
SAFETY_ALERTS_EXPLANATION.docx		2018-05-25
SAFETY_ALERT_PAPER_FORM_INSTRUCTIONS.doc		2017-03-02
TRANSITIONAL_YOUTH_REFERRAL_PLAN_FORM_FILL.doc		2018-05-25
TRANSITIONAL_YOUTH_REFERRAL_PLAN_EXPLANATION.docx		2018-05-25
TRANSITIONAL_AGE_YOUTH_REFERRAL_P&P.doc		2017-03-02
TIERS_VOCATIONAL_EMPLOYMENT.docx		2018-05-25
YOUTH_TRANSITION_SELF_EVALUATION_VIETNAMESE.doc		2018-05-25
YOUTH_TRANSITION_SELF_EVALUATION_SPANISH.doc		2018-05-25
VITALS_FORMFILL.doc		2017-03-02
REQUEST_FOR_ACCESS_COPY_OF_PHI.doc		2017-02-17
RELEASE_OF_INFORMATION_CHILD_04-24A-P.dot		2017-02-17
PSYCHIATRIC_ASSESSMENT_PAPER_FORM_INSTRUCTIONS.doc		2017-02-17
MY_SAFETY_PLAN_FORM_FILL_TAGALOG.docx		2018-01-19
MY_SAFETY_PLAN_FORM_FILL_ENGLISH.docx		2018-01-19
MY_SAFETY_PLAN_FORM_FILL_ARABIC.docx		2018-01-19
MY_SAFETY_PLAN_EXPLANATION.docx		2018-06-21
MORS_ADULT_OUTCOME_MEASURE.docx		2018-05-25
MEDICAL_CONDITION_REVIEW_FORM_EHR.docx		2018-05-25
MEDICAL_CONDITION_REVIEW_EXPLANATION.docx		2018-05-25
MY_SAFETY_PLAN_FORM_FILL_VIETNAMESE.docx		2018-01-19
IMR_CLINICIAN_VERSION_072910.pdf		2018-05-25
HIGH_RISK_INDEX_FORM_FILL.docx		2018-05-25
HIGH_RISK_ASSESSMENT_FORM_FILL.docx		2018-05-25
ECBI_EXPLANATION.docx		2018-05-25
INITIAL_SCREENING_PAPER_FORM_INSTRUCTIONS.doc		2017-02-17
INITIAL_SCREENING_EXPLANATION.docx		2018-05-25
INITIAL_SCREENING_ESU_PAPER_FORM_INSTRUCTIONS.doc		2017-02-17
DEMOGRAPHIC FORM EXPLANATION (docx)		2018-05-25
DAY TREATMENT CLIENT PLAN (doc)		2017-02-17
COORDINATION_OF_CARE_FORM_EXPLANATION.docx		2018-05-25
COORDINATION OF CARE FORM (docx)		2018-05-25
CONSENT FOR SERVICES EXPLANATION (docx)		2018-05-25
CONSENT FOR SERVICES (docx)		2018-05-25
CLIENT INFORMATION FACE SHEET EXPLANATION (docx)		2018-05-25
BHA - TBS PAPER FORM INSTRUCTIONS (doc)		2017-02-17
Authorization to Use or Disclose PHI - VIETNAMESE (pdf)	Vietnamese	2017-02-17
Authorization to Use or Disclose PHI - TAGALOG (pdf)	Tagalog	2017-02-17
Authorization to Use or Disclose PHI - SPANISH (pdf)	Spanish	2017-02-17
Authorization to Use or Disclose PHI - ENGLISH (pdf)	English	2017-02-17
Authorization to Use or Disclose PHI - CHILD (dot)		2017-02-17
Authorization to Use of Disclose PHI - ARABIC (pdf)	Arabic	2017-02-17
AIMS_EXPLANATION.docx		2018-05-25
ADVANCE DIRECTIVE ADVISEMENT EXPLANATION (docx)		2018-05-25
ADVANCE DIRECTIVE ADVISEMENT (doc)		2018-05-25
ACKNOWLEDGEMENT NPP (docx)		2018-05-25

UTTM


QM...Up to the Minute - January 2021 (pdf)	2021	2021-01-15
QM...Up to the Minute - December 2020 (pdf)	2020	2020-12-16
QM...Up to the Minute - November 2020 (pdf)	2020	2020-11-12
QM...Up to the Minute - October 2020 (pdf)	2020	2020-10-09
QM...Up to the Minute - September 2020 (pdf)	2020	2020-09-11
QM...Up to the Minute - August 2020 (pdf)	2020	2020-08-13
QI...Up to the Minute - FY 2019 -2020 (pdf)	2020	2020-07-31
QM...Up to the Minute - July 2020	2020	2020-07-10
QM...Up to the Minute - June 2020	2020	2020-06-12
OM...Up to the Minute - May 2020 (pdf)	2020	2020-05-15
QM...Up to the Minute - April 2020 (pdf)	2020	2020-04-09
QM...Up to the Minute - March 2020 (pdf)	2020	2020-03-31
QM...Up to the Minute - February 2020 (pdf)	2020	2020-02-13
QM...Up to the Minute - January 2020 (pdf)	2020	2020-02-13
QM...Up to the Minute - December 2019 (pdf)	2019	2020-02-13
QM...Up to the Minute - October 2019 (pdf)	2019	2019-10-10
QM...Up to the Minute - November 2019 (pdf)	2019	2019-11-20
QM...Up to the Minute - September 2019 (pdf)	2019	2019-09-24
QI...Up to the Minute - FY 2018-2019 (pdf)	2018-2019	2019-09-24
QM...Up to the Minute - July 2019 (pdf)	2019	2019-07-23
QI...Up to the Minute - August 2019 (pdf)	2019	2019-08-14
QI...Up to the Minute - June 2019 (pdf)	2019	2019-07-11
QI...Up to the Minute - May 2019 (pdf)	2019	2019-05-10
QI...Up to the Minute - April 2019 (pdf)	2019	2019-04-12
QI...Up to the Minute - March 2019 (pdf)	2019	2019-03-14
QI...Up to the Minute - February 2019 (pdf)	2019	2019-02-15
QI...Up to the Minute - January 2019 (pdf)	2019	2019-01-10

Training

Reports Demonstration available online (new)
SET Orientation and Practice Exercises available online (new)
Admin Data Entry Orientation and Practice Exercises available online (new)
Scheduler Orientation and Practice Exercises available online (new)
Doctor's Homepage Orientation and Practice Exercises available online (new)
Crisis House Assessments Orientation and Practice Exercises available online (new)
Assessments Orientation and Practice Exercises available online
Progress Notes Orientation and Practice Exercises available online
Client Plans and Progress Notes Orientation and Practice Exercises available online

Access to Services Journal Video Tutorial available online.
Progress Notes and Service Codes Webinar available online (new)
NOABD Webinar available online
Service Indicators Webinar available online
BHA Webinar available online
Client Plan Webinar available online
Progress Notes v3 Video Tutorials available online
Billing Correction Tutorials available online
CCBH Login Process Tutorial available online

Training Resources Packet

Progress Note Correction Resources

Other Training Resources and Tip Sheets

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 (06-28-18) (docx)		2018-07-02
Child and Family Team (CFT) Meeting Note Explanation (pdf)		2018-06-21
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 (10-4-18) (pdf)		2018-10-05
Progress Report to Child Welfare Services Form Fill (10-4-18) (docx)		2018-10-05

BHS Reports


AOA Annual Medication Monitoring Report FY 16-17 (pdf)		2017-11-30
AOA Annual Medication Monitoring Report Q2 FY17-18 (pdf)		2018-02-12
BHS Dashboard October 2017 (pdf)		2017-11-07
BHSDatabook_FY16-17_Final.pdf		2018-02-09
BHSDatabook_FY2014-15.pdf		2016-05-25
CYF Annual Medication Monitoring Report FY 16-17 (pdf)		2017-11-30
CYF Medication Monitoring Report Q2 FY17-18 (pdf)		2018-02-12
FY_2016-17_BHS_Factsheet_Combined_FINAL.pdf		2018-02-09
Medical Record Reviews FY 2017-18 Trending Questions Summary AOA and CYF Programs Q3 FY 2017-18 (pdf)		2018-05-01
Mental Health Performance Dashboard Combined - FY2017-18 (pdf)		2018-01-22
QM - MRR - Trending Questions Report - Q1 FY 18-19 (pdf)		2018-10-05
QM - MRR - Trending Questions Report - Q1 FY 19-20 (pdf)		2019-10-25
QM - MRR - Trending Questions Report - Q2 FY 18-19 (pdf)		2019-01-24
QM - MRR - Trending Questions Report - Q3 FY 18-19 (pdf)		2019-05-01
QM – MRR – Trending Questions – Q1 FY 20-21 (pdf)		2020-10-28

STRTP


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
STRTIP UTILIZATION MANAGEMENT REQUEST – EXPLANATION (pdf)	Revised 11/20/2020	2020-11-25
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)		2020-11-25
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 (DSR) (docx)	Revised 11/20/2020	2020-11-25
STRTP PRIOR DAY AUTHORIZATION DAY SERVICES REQUEST - EXPLANATION (pdf)	Revised 11/20/2020	2020-11-25
STRTP TRANSITION DETERMINATION PLAN FORM FILL (docm)	Revised 11/20/2020	2020-11-25
STRTP TRANSITION DETERMINATION PLAN – EXPLANATION (pdf)	Revised 11/20/2020	2020-11-25
STRTP UTILIZATION MANAGEMENT REQUEST FORM FILL (docx)	Revised 11/20/2020	2020-11-25

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
CCBH TFC DAILY PROGRESS NOTE FORM FILL (doc)		2020-11-25
TFC ANNUAL PARENT AGREEMENT AND CERTIFICATION FORM FILL (docx)		2020-11-25
TFC CLINICAL DOCUMENTATION TIP SHEET (pdf)		2020-11-25
TFC DAILY PROGRESS NOTE- EXPLANATION (pdf)		2020-11-25
TFC PARENT DOCUMENTATION TIP SHEET (pdf)		2020-11-25
TFC PRIOR AUTHORIZATION REQUEST - EXPLANATION (pdf)		2020-11-25
TFC PRIOR AUTHORIZATION REQUEST FORM FILL (doc)		2020-11-25