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PROVIDER QUICK LINKS


MHP 22-27 Placer State County Contract (PDF)
Behavioral Health QA Report Template (DOC)
Behavioral Health QIC Report Template (DOC)
QI Annual Plan TEMPLATE (PDF)
Beneficiary Informing Materials
Placer County Drug Medi-Cal Practice Guidelines
Placer/Sierra Mental Health Plan Network Provider Manual (PDF)
Request for Authorization/Treatment Plan Report Template (Care009e)
Consent to Treat a Minor Template (Care036)
Consent for Medication Template (Care207)
Progress Notes Template (Care041e)
Example of Well-written Progress Notes (PDF)
Department of Health Care Services Mental Health Provider 17-94602 (PDF)
Criteria for Beneficiary Access to Specialty Mental Health Services (PDF)
FY 22-23 MH INP Audit Schedule - Quick view (PDF)
FY 22-23 MH Org-SUD Audit Schedule - Quick view (PDF)

Placer DMC-ODS Beneficiary Handbook
Placer DMC-ODS Beneficiary Handbook (Spanish)
Placer DMC-ODS Beneficiary Handbook (Large Print)
Placer DMC-ODS Beneficiary Handbook (Large Print, Spanish) 

Placer MHP Beneficiary Handbook
Placer MHP Beneficiary Handbook (Spanish)
Placer MHP Beneficiary Handbook (Large Print)
Placer MHP Beneficiary Handbook (Large Print, Spanish) 

Nondiscrimination Notice
Nondiscrimination Notice (Spanish) 

Language Taglines
NOABD Authorization Delay
NOABD Delivery System Notice
NOABD Denial Notice
NOABD Financial Liability Notice
NOABD Grievance and Appeal Timely Resolution Notice 
NOABD Modification Notice
NOABD Payment Denial Notice
NOABD Termination Notice
NOABD Timely Access Notice Placer

DHCS Ongoing Monitoring and Enforcement Actions