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MHP Provider Documents

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

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

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

COVID-19

Latest Update

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

Reporting Guidance

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 English (pdf)
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Tagalog.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Spanish.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Korean.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Persian(Farsi).pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Arabic.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Vietnamese.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Dari.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Somali.pdf
Effective 03/12/2023 2023-03-10
MHP Beneficiary Handbook_2.2023_Chinese.pdf
Effective 03/12/2023 2023-03-10
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
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 SIR FAQ and Tip Sheet (pdf)
Updated 07/24/2023 2023-07-25
BHS SIROF FAQ and Tip Sheet (pdf)
Revised 06/30/2023 2023-07-06
BHS Serious Incident Report of Findings (docx)
Revised 06/30/2023 2023-07-06
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
DEMOGRAPHIC FORM FILL (docx)
Revised 06/01/2021 2021-05-28
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 01/12/2023 2023-12-07
Med Monitoring Submission Form - Childrens (xlsx)
Revised 04/24/2023 2023-12-07
Med Monitoring Tool AOA (docx)
Revised 10/26/2022 2022-10-26
Med Monitoring Tool CYF (docx)
Revised 10/26/2022 2022-12-09
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
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
Serious Incident Report (docx)
Updated 07/24/2023 2023-07-25
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 07/12/2023 2023-07-14
Written Translation Service Authorization Form (pdf)
2021-03-12

Manuals

OPOH
01 - Cover Sheet Org Provider Manual (pdf )
2018-09-20
02 - Table of Contents Org Prov Op Handbook (pdf)
Revised on 08/22/2023 2023-08-24
03 - OPOH - Customer Service Mission (pdf)
Revised 04/08/2020 2020-04-09
04 – OPOH – Section A – Systems of Care (pdf)
Revised 09/01/2022 2022-08-15
05 - OPOH - Section B - Compliance Confidentiality (pdf)
Revised 09/12/2023 2023-09-20
06 – OPOH – Section C – Accessing Services (pdf)
Revision 09/19/2023 2023-09-22
07 – OPOH – Section D – Providing Specialty Mental Health Services (pdf)
Revision 12/01/2023 2023-12-07
08 - OPOH - Section E - Integration with Physical Healthcare (pdf)
Revised 06/29/2023 2023-07-06
09 - OPOH - Section F - Beneficiary Rights Grievance Appeals (pdf)
Revised 06/09/2023 2023-11-09
10 - OPOH - Section G - Quality Improvement (pdf)
Revised 09/29/2023 2023-10-04
11 – OPOH – Section H – Cultural Competency (pdf)
Revised 09/15/2023 2023-09-20
12 - OPOH - Section I Management Info System (pdf)
Revised 02/21/2020 2020-03-02
13 - OPOH - Section J - Provider Contracting (pdf)
Revised 08/22/2023 2023-08-24
14 - OPOH - Section K - Provider Issue Resolution (pdf)
Revised 02/19/2020 2020-03-02
15 – OPOH – Section L – Practice Guidelines (pdf)
Revised 04/03/2023 2023-05-17
16 – OPOH – Section M – Staff Qualifications (pdf)
Revised 09/01/2023 2023-09-07
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 08/17/2023 2023-08-22
MIS-25 Program Listing Report (xlsx)
Revised 11/06/2023 2023-11-08
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
RCA WORKSHEET Sample (pdf)
2021-03-12
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 (docx)
Revised 05/05/2023 2023-05-09
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
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 Explanation (docx)
Revised 10/17/2023 2023-10-23
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
DAY TREATMENT WEEKLY SUMMARY (doc)
2020-01-22
DAY TREATMENT WEEKLY SUMMARY INSTRUCTIONS (docx)
2020-01-22
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)
2023-01-05
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 10/20/2023 2023-10-24
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 11/21/2023 2023-11-28
IHBS PRIOR AUTHORIZATION REQUEST FORM FILL (pdf)
Revised 11/21/2023 2023-12-04
IHBS PRIOR AUTHORIZATION WEB BASED SUBMISSION FORM - INSTRUCTIONS (docx)
2023-09-08
IMR ADULT OUTCOMES EXPLANATION (docx)
2018-02-13
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 FORM FILL (docx)
2023-12-04
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)
2020-09-17
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
Peer Support CP PN Form Fill (docx)
Revised 10/16/2023 2023-10-23
Peer Support MHSA CP Explanation Sheet (docx)
Revised 10/17/2023 2023-10-23
Problem List - FormFill (docx)
Revised 08/29/2022 2022-08-25
Problem List Explanation (docx)
Revised 10/12/2023 2023-10-23
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 - November 2023 (pdf)
2023 2023-11-17
QM…Up to the Minute - October 2023 (pdf)
2023 2023-10-16
QM...Up to the Minute - September 2023 (pdf)
2023 2023-09-18
QM...Up to the Minute - August 2023 (pdf)
2023 2023-08-11
QM...Up to the Minute - July 2023 (pdf)
2023 2023-07-15
QM...Up to the Minute - June 2023 (pdf)
2023 2023-06-09
QM...Up to the Minute - May 2023 (pdf)
2023 2023-05-12
QM...Up to the Minute - April 2023 (pdf)
2023 2023-04-14
QM...Up to the Minute - March 2023 (pdf)
2023 2023-03-14
QM...Up to the Minute - February 2023 (pdf)
2023 2023-02-10
QM...Up to the Minute - January 2023 (pdf)
2023 2023-01-13
QM...Up to the Minute -December 2022 (pdf)
2022 2022-12-13
QM...Up to the Minute -November 2022 (pdf)
2022 2022-11-14
QM...Up to the Minute - October 2022 (pdf)
2022 2022-10-18
QM...Up to the Minute - September 2022 (pdf)
2022 2022-10-18
QM...Up to the Minute - August 2022 (pdf
2022 2022-08-12
QM...Up to the Minute - July 2022 (pdf)
2022 2022-07-20
QI...Up to the Minute - FY 2021 -2022 (pdf)
2021 - 2022 2022-09-20
QM...Up to the Minute - April 2022 (pdf)
2022 2022-04-15
QM...Up to the Minute - August 2021 (pdf)
2021 2021-08-12
QM...Up to the Minute - December 2021 (pdf)
2021 2021-12-13
QM...Up to the Minute - February 2022 (pdf)
2022 2022-02-10
QM...Up to the Minute - January 2022 (pdf)
2022 2022-01-25
QM...Up to the Minute - July 2021 (pdf)
2021 2021-07-08
QM...Up to the Minute - June 2022 (pdf)
2022 2022-06-10
QM...Up to the Minute - March 2022 (pdf)
2022 2022-03-30
QM...Up to the Minute - May 2022 (pdf)
2022 2022-05-13
QM...Up to the Minute - November 2021 (pdf)
2021 2021-11-12
QM...Up to the Minute - October 2021 (pdf)
2021 2021-10-14
QM...Up to the Minute -September 2021 (pdf)
2021 2021-09-10

Training

CCBH Training page - Tips and Resources

Training Classes Video Tutorials and Resource Packets

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

Progress Note Correction Resources

Progress Notes Correction Video Tutorials
Billing Correction Tutorials

Other Training Resources and Tip SheetS

Reports Demonstration

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

PWB
Explanation_for_Eligibility_form-10-25-17.pdf
2017-11-07
Eligibility-for-PWB-and-Enhanced-Services-Form-Fill-09.20.2017.docx
2017-11-07
Child and Family Team CFT Meeting Note Form Fill 07.07.23 (docx)
2023-07-11
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 04/01/2022 2022-03-25
TFC PRIOR AUTHORIZATION REQUEST - EXPLANATION (docx)
Revised 04/01/2022 2022-03-25

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

EHR Implementation

System of Care (SOC) EHR Implementation

SOC Resources

EHR Implementation Information Notices
2023-11-17 BHS Provider Memo EHR Implementation Update (pdf)
2023-11-28

EHR Town Halls | 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