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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.

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COVID-19

Latest Update

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Other COVID-19 Resources and Updates

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 Log – FY 21-22 (xlsx)
2021-07-19
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 (pdf)
Revised 01/08/2020 2020-01-08
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

MHP Beneficiary Handbook_January 2024_English (pdf)
Effective 01/01/2024 2024-02-23
MHP Beneficiary Handbook_January 2024_English_Large Font (pdf)
Effective 01/01/2024 2024-02-23
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
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Spanish_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Farsi_Large Print.pdf
Effective 01/01/2024 2024-01-26
MHP Beneficiary Handbook_January 2024_Vietnamese_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Somali.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Chinese (Trad).pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Spanish.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Somali_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Farsi_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Tagalog.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Chinese (Trad)_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Korean.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Vietnamese.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Dari_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Arabic.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Arabic_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Dari.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Korean_Large Font.pdf
Effective 01/01/2024 2024-02-08
MHP Beneficiary Handbook_January 2024_Farsi.pdf
Effective 01/01/2024 2024-02-08
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
Physician Notice to Patients California Regulation - Dari (pdf)
2023-11-09
Physician Notice to Patients California Regulation - Somali (pdf)
2023-11-09
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
Quick Guide To MH Services-Vietnamese (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Chinese (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Somali (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Spanish (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Farsi (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Tagalog (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Korean (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-English (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Dari (pdf)
Revised 07/11/2023 2023-11-06
Quick Guide To MH Services-Arabic (pdf)
Revised 07/11/2023 2023-11-06
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
Beneficiary Materials MHP Order Form (pdf)
Revised 10/11/2023 2023-10-24
Physician Notice to Patients California Regulation - Arabic (pdf)
2023-05-09
Physician Notice to Patients California Regulation - Chinese (pdf)
2023-05-09
Physician Notice to Patients California Regulation - English (pdf)
2023-05-09
Physician Notice to Patients California Regulation - Farsi (pdf)
2023-05-09
Physician Notice to Patients California Regulation - Korean (pdf)
2023-05-09
Physician Notice to Patients California Regulation - Spanish (pdf)
2023-05-09
Physician Notice to Patients California Regulation - Tagalog (pdf)
2023-05-09
Physician Notice to Patients California Regulation - Vietnamese (pdf)
2023-05-09
Advance Directive - Farsi (pdf)
2023-05-04
Advance Directive – Arabic (pdf)
2023-05-04
Advance Directive - Dari (pdf)
2023-05-04
Advance Directive – Tagalog (pdf)
2023-05-04
Advance Directive – Spanish (pdf)
2023-05-04
Advance Directive – Vietnamese (pdf)
2023-05-04
Advance Directive – English (pdf)
2023-05-04
Advance Directive - Korean (pdf)
2023-05-04
Advance Directive – Chinese (Traditional) (pdf)
2023-05-04
Advance Directive – Somali (pdf)
2023-05-04
Limited English Proficiency Poster – Chinese (Traditional)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Spanish (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Korean (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Tagalog (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Dari (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Somali (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Vietnamese (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Arabic (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Farsi (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – English (pdf)
Revised 04/2023 2023-05-02
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 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 - Farsi (docx)
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

2024-02-06- 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 - 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
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 A (docx)
Revised 4/2021 2021-11-09
BHS 025 Form B (docx)
Revised 4/2021 2021-11-09
BHS-025 Form A and B Tip Sheet (docx)
Client Information - Revised 4/2019 2019-05-02
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)
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 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 12/19/2023 2023-12-20
Med Monitoring Tool CYF (docx)
Revised 03/13/2024 2024-03-13
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

03 - OPOH - Customer Service Mission (pdf)
Revised 04/08/2020 2020-04-09
04 – OPOH – Section A – Systems of Care (pdf)
Revised 01/24/2024 2024-01-30
01 - Cover Sheet Org Provider Manual (pdf )
Revised 12/01/2023 2023-12-13
02 - Table of Contents Org Prov Op Handbook (pdf)
Revised 02/02/2024 2024-02-12
05 - OPOH - Section B - Compliance Confidentiality (pdf)
Revised 09/12/2023 2023-09-20
06 – OPOH - Section C - Accessing Services (pdf)
Revised 01/12/2024 2024-01-17
07- OPOH- Section D- Providing Specialty Mental Health Services (pdf)
Revised 12/20/2023 2023-12-22
08 - OPOH - Section E - Integration with Physical Healthcare (pdf)
Revised 02/29/2024 2024-03-04
09 - OPOH - Section F - Beneficiary Rights Grievance Appeals (pdf)
Revised 03/07/2024 2024-03-11
10 – OPOH – Section G - Quality Improvement (pdf)
Revised 12/20/2023 2023-12-21
11 – OPOH – Section H – Cultural Competency (pdf)
Revised 01/05/2024 2024-01-10
12 – OPOH – Section I – Management Info System (pdf)
Revised 12/12/2023 2023-12-20
13 - OPOH - Section J - Provider Contracting (pdf)
Revised 12/27/2023 2024-01-09
14 - OPOH - Section K - Provider Issue Resolution (pdf)
Revised 02/19/2020 2020-03-02
15 – OPOH – Section L – Practice Guidelines (pdf)
revised 02/01/2024 2024-02-06
16- OPOH- Section M - Staff Qualifications (pdf)
Revised 01/09/2024 2024-01-17
17 - OPOH - Section N - Data Requirements (pdf)
Revised 04/21/2023 2023-05-17
18 - OPOH - Section O - Training (pdf)
Revised 04/03/2023 2023-05-17
19 - OPOH - Section P - Mental Health Services Act (pdf)
Revised 03/11/2022 2022-03-17
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
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
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

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 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)
Revised 02/12/2024 2024-02-15
MRR Tool - FY 23-24 (xlsx)
Revised 08/28/2023 2023-09-01
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
New Contractor Orientation Resources (pdf)
Revised 11/21/2023 2023-11-28
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 Changes Grid FY22-23 (docx)
2023-02-08
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

10 2018 PSC - Parent interactive (pdf)
Revised 3/2020 2020-03-26
10 2018 PSC - Youth Interactive (pdf)
Revised 3/2020 2020-03-26
ACKNOWLEDGEMENT NPP (docx)
2018-05-25
ADVANCE DIRECTIVE ADVISEMENT (doc)
2018-05-25
ADVANCE DIRECTIVE ADVISEMENT EXPLANATION (docx)
2018-05-25
AIMS FORM FILL (doc)
2018-02-13
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
AOA Patient Medication Agreement English (pdf)
2018-06-08
AUTHORIZATION TO USE OR DISCLOSE PHI (docx)
2023-08-21
AUTHORIZATION TO USE OR DISCLOSE PHI EXPLANATION (docx)
2018-02-09
Adult Clinical Record Chart Order (docx)
Revised 02/09/2023 2023-02-10
BHA - EXPLANATION (docx)
Revised 08/21/2023 2023-08-29
BHA – 0-5 FORMFILL (docx)
Revised 02/10/2023 2023-02-14
BHA – ADULT FORM FILL (doc)
Revised 02/10/2023 2023-02-14
BHA – CHILDREN FORM FILL (docx)
Revised 02/10/2023 2023-02-14
BHA – DEC FORM FILL (docx)
Revised 02/10/2023 2023-02-14
CANS EXPLANATION (docx)
Revised 09/11/2023 2023-09-12
CANS Family Letter (pdf)
2019-03-29
CARE PLAN EXPLANATION (docx)
Revised 12/26/2023 2024-01-05
CLIENT ASSIGNMENT FORM (doc)
2018-08-14
CLIENT INFORMATION FACE SHEET EXPLANATION (docx)
2018-05-25
CONSENT FOR SERVICES (docx)
Revised 01/31/2023 2023-03-14
CONSENT FOR SERVICES EXPLANATION (docx)
2018-05-25
COORDINATION OF CARE FORM (docx)
2018-05-25
COORDINATION OF CARE FORM EXPLANATION (docx)
2018-05-25
CRISIS STABILIZATION UNIT DAILY DOCUMENTATION PROGRESS NOTE (docx)
Revised 06/11/2021 2021-06-24
CRISIS STABILIZATION UNIT DISCHARGE PROGRESS NOTE (docx)
Revised 06/11/2021 2021-06-24
CRISIS STABILIZATION UNIT REASSESSMENT PROGRESS NOTE (docx)
Revised 06/11/2021 2021-06-24
CSU EPISODE SUMMARY (docx)
2023-03-29
CSU EPISODE SUMMARY – EXPLANATION (docx)
2023-03-29
Child and Family Team CFT Meeting Note Form Fill 07.07.23 (docx)
2023-07-11
Children’s Uniform Chart Order (docx)
Revised 02/09/2023 2023-02-10
Client Plan Form Fill (docx)
2023-08-15
Client Plan Signature Page (docx)
2023-08-21
Consent for Services (docx)
Revised 01/31/2023 2023-02-08
DAY TREATMENT CLIENT PLAN (doc)
2017-02-17
DEMOGRAPHIC FORM EXPLANATION (docx)
Revised 05/2021 2021-05-20
DEMOGRAPHIC FORM FILL (docx)
Revised 09/22/2022 2023-02-17
DIAGNOSIS FORM (docx)
2018-02-13
DIAGNOSIS FORM EXPLANATION (docx)
Revised 10/12/2023 2023-10-23
DISCHARGE SUMMARY EXPLANATION (docx)
Revised 10/12/2023 2023-10-23
DISCHARGE SUMMARY FORMFILL (docx)
Revised 10/30/2023 2023-11-17
DISCHARGE SUMMARY PAPER FORM INSTRUCTIONS (docx)
Updated 11/07/2023 2023-11-09
Daily Progress Note (docx)
2023-01-05
Daily Progress Note Explanation Sheet (docx)
Revised 02/01/2024 2024-02-06
ECBI EXPLANATION (docx)
2018-05-25
ESU NURSING NOTE FORM FILL (docx)
2020-08-17
Explanation for Eligibility Form (pdf)
2017-10-25
General Progress Note (docx)
Revised 08/26/2022 2022-08-25
General Progress Note Explanation Sheet (docx)
Revised 02/01/2024 2024-02-06
Group Progress Note (docx)
2023-01-05
Group Progress Note Explanation Sheet (docx)
Revised 10/20/2023 2023-10-24
HIGH RISK ASSESSMENT EXPLANATION (docx)
Revised 10/12/2023 2023-10-23
HIGH RISK ASSESSMENT FORM FILL (docx)
2018-05-25
HIGH RISK INDEX FORM FILL (docx)
2018-05-25
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
INITIAL SCREENING FORMFILL (docx)
Revised 02/10/2023 2023-02-14
INITIAL SCREENING PAPER FORM INSTRUCTIONS (doc)
Revised 02/10/2023 2023-02-14
INITIAL SCREENING PERT FORMFILL (docx)
Revised 02/10/2023 2023-02-14
INITIAL SCREENING PERT PAPER FORM INSTRUCTIONS (docx)
Revised 02/10/2023 2023-02-14
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
MCRT ASSESSMENT (docx)
Revised 11/02/2021 2022-01-25
MEDICAL CONDITION REVIEW EXPLANATION (docx)
2018-05-25
MEDICAL CONDITION REVIEW FORM EHR (docx)
2018-05-25
MEDICATION PROGRESS NOTE (docx)
Revised 07/06/2023 2023-08-09
MEDS MANAGEMENT LONG NOTE FORM FILL (doc)
2020-08-07
MOBILE CRISIS ASSESSMENT (docx)
2023-05-30
MORS ADULT OUTCOME EXPLANATION (docx)
2018-02-13
MORS ADULT OUTCOME MEASURE (docx)
2018-05-25
MY SAFETY PLAN EXPLANATION (docx)
Revised 12/01/2023 2023-12-04
MY SAFETY PLAN FORM FILL ENGLISH (docx)
Revised 11/30/2023 2023-12-04
NEVER BILLABLE PROGRESS NOTE FORM FILL (doc)
2020-03-18
NURSING NOTE FORM FILL (docx)
2024-03-13
PRIOR AUTHORIZATION DAY SERVICES REQUEST (docx)
Revised 04/01/2022 2022-03-25
PRIOR AUTHORIZATION DAY SERVICES REQUEST – EXPLANATION (docx)
2022-06-13
PROSPECTIVE RISK ANALYSIS (PRA) (docx)
Revised 05/2021 2021-05-28
PROSPECTIVE RISK ANALYSIS PRA EXPLANATION (docx)
Revised 10/30/2023 2023-11-02
PSC-35 Explanation (docx)
Revised 08/20/2021 2021-08-20
PSYCHIATRIC ASSESSMENT EHR EXPLANATION (docx)
2019-12-12
PSYCHIATRIC ASSESSMENT FORM FILL (doc)
2018-02-13
PSYCHIATRIC ASSESSMENT PAPER FORM INSTRUCTIONS (doc)
2017-02-17
Problem List - FormFill (docx)
Revised 08/29/2022 2022-08-25
Problem List Explanation (docx)
Revised 12/14/2023 2023-12-19
RELEASE OF INFORMATION CHILD 04-24A-P (dot)
2017-02-17
REQUEST FOR ACCESS COPY OF PHI (doc)
2017-02-17
Recovery Markers Questionnaire Form 093009 (pdf)
2020-07-14
SAFETY ALERT PAPER FORM INSTRUCTIONS (doc)
2017-03-02
SAFETY ALERTS EXPLANATION (docx)
2018-05-25
SAFETY ALERTS FORM FILL (doc)
2018-02-13
SATS-R ADULT OUTCOME EXPLANATION (docx)
2018-02-13
SATS-R FORM 2 (doc)
2017-03-02
SD-CANS Explanation (docx)
Revised 05/14/2021 2021-10-26
STRENGTHS TABLE (docx)
2018-05-25
Service Indicator Outside Facility ID Listing (xlsx)
Revised 11/2023 2023-12-04
Service Indicator Table Key (docx)
2020-03-18
TIERS ABUSE ADDICTION (docx)
2018-05-25
TIERS BASIC NEEDS (docx)
2018-05-25
TIERS EDUCATION (docx)
2018-05-25
TIERS EMOTIONAL BEHAVIORAL PSYCHIATRIC (docx)
2018-02-09
TIERS FAMILY STRESS (docx)
2018-05-25
TIERS FINANCIAL (docx)
2018-05-25
TIERS IDENTITY ISSUES (docx)
2018-05-25
TIERS INTIMATE RELATIONSHIPS (docx)
2018-05-25
TIERS LACK OF PHYSICAL HEALTH CARE (docx)
2018-05-25
TIERS LEGAL (docx)
2018-05-25
TIERS MEANINGFUL ROLE (docx)
2018-05-25
TIERS NEGLECT ABUSE (docx)
2018-05-25
TIERS NEUROLOGICAL BRAIN IMPAIRMENT (docx)
2018-05-25
TIERS PHYSICAL HEALTH PROBLEMS (docx)
2018-05-25
TIERS POTENTIAL FOR HARM (docx)
2018-05-25
TIERS SOCIAL FUNCTIONING (docx)
2018-05-25
TIERS SPIRITUAL (docx)
2018-05-25
TIERS STRESS (docx)
2018-05-25
TIERS TABLE EXPLANATION (docx)
2018-05-25
TIERS TRAUMA (docx)
2018-05-25
TIERS VOCATIONAL EMPLOYMENT (docx)
2018-05-25
TRANSITIONAL AGE YOUTH REFERRAL P&P (doc)
2017-03-02
TRANSITIONAL YOUTH REFERRAL PLAN EXPLANATION (docx)
2018-05-25
TRANSITIONAL YOUTH REFERRAL PLAN FORM FILL (doc)
2018-05-25
UM Request Explanation Sheet (docx)
Revised 07/01/2022 2022-06-21
UM Request Form (pdf)
Revised 07/01/2022 2023-05-08
VITALS FORM FILL (doc)
2017-03-02
WALK IN ASSESSMENT PROGRESS NOTE FORM FILL (doc)
2020-08-07
WRAPAROUND PROGRESS NOTE FORM FILL (doc)
2020-08-10
YOUTH TRANSITION SELF EVALUATION EXPLANATION (docx)
2021-08-20
Youth Transition Self Evaluation Formfill (docx)
2020-06-18

UTTM

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


Training Classes Video Tutorials and Resource Packets


Progress Note Correction Resources


Other Training Resources and Tip SheetS

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
Child and Family Team CFT Meeting Note Form Fill 11.30.2021 (docx)
2021-12-02
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

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

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)
2020-11-25
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

SOC Resources

EHR Implementation FAQ 2-14-24 (pdf)
2024-02-16
SmartCare Hardware_Software and Network Requirements - March 2024 update (pdf)
2024-03-18
SmartCare_Hardware_Software and System Requirements (pdf)
2024-03-04

Information Notices

2023-11-17 BHS Provider Memo EHR Implementation Update (pdf)
2023-11-28
2024-02-16 BHS Provider memo-EHR Update (pdf)
2024-02-16
2024-03-05 BHS Provider Memo EHR Update (pdf)
2024-03-06

Town Hall PowerPoint Presentations

2023-05-16 Cerner Millennium Town Hall (pdf)
May 2023 Town Hall
2023-07-11 Cerner Millennium Town Hall (pdf)
July 2023 Town Hall 2023-07-21
2023-08-07 Cerner Millennium Town Hall (pdf)
August 2023 Town Hall 2023-08-09
2023-09-12 Cerner Millennium Town Hall (pdf)
September 2023 Town Hall 2023-09-18
2023-10-17 Cerner Millennium Town Hall (pdf)
October 2023 Town Hall 2023-10-19
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

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 07/31/2012 2024-02-29