Section 4: Provider Relations

​​​​​​​​​​​​​​​​​​​​​​​​​​​​Table of Contents - Medi-Cal


​​​​​Policy/Procedure Title​​

Policy Number
Last Review /
Revision Date
​​          Summary of PHC​ Access and Availability Standards​​
​          PHC Provider Directory
​          Introduction to the Provider Relations Department

Credentials Committee

 MP CR  1

04/11/2017

Credentialing and Re-cred​​entialing Committee Authority and Responsibility

​ MP CR  2

10/11/2017

Credentials Committee Review

 MP PR-PL-CR  201

08/09/2017

Initial Credentialing Requirements

​ MP CR  4

08/09/2017

Addendum to CP​PA: Credentialing Rights and​Responsibilities​​

​​

Initial Credentialing Criteria, Application/Attestation, and Monitoring of Sanctions for Behavioral Health Practitioners

 MP CR  4 A

08/09/2017

Identification of HIV/AIDS Specialists 

 MP CR  4 B

06/14/2017

Identification and Notification of HIV/AIDs Specialist Attestation Questionnaire​​​​​​

Credentials Document Collection, Review, and Verification

 MP PR-PL-CR  401

03/08/2017

​​​​​​Addendum to CPPA: Credentialing Rights and Responsibilities

Credentials Document Collection, Review, and Verification for Behavioral Health Practitioners

 MP PR-PL-CR  401 A

02/08/2017

Review Standards for Credentials, Re-credential Process

 MP CR  5

08/09/2017

Non-Physician Medical Practitioner Credentialing Criteria

 MP CR  6

08/09/2017

​​​​​​​​Addendum to CPPA: Credentialing Rights and Responsibilities

​​

Initial Credentialing Requirements for Non-Physician (Allied Health) Practitioners

 MP CR  6 A

02/08/2017

Re-credentialing Requirements

 MP CR  7

08/09/2017

​​​​​Addendum to CPPA: Credentialing Rights and Responsibilities

Re-credentialing Criteria, Application/Attestation, and Monitoring of Sanctions for Behavioral Health Practitioners

 MP CR  7 A

08/09/2017

Re-credentialing Document Collection, Review and Verification and Ongoing Monitoring of Sanctions and Complaints

 MP PR-PL-CR  701

08/09/2017

​​​​​Addendum to CPPA: Credentialing Rights and Responsibilities

Re-credentialing Document Collection, Review and Verification and Ongoing Monitoring of Sanctions and Complaints for Behavioral Health Practitioners

​​

 MP PR-PL-CR  701 A

08/09/2017

​​​​Addendum to CPPA: Credentialing  Rights and Responsibilities

Non-Physician Medical Practitioner Re-credentialing Criteria

 MP CR  8

06/14/2017

​​​​​​Addendum to CPPA: Credentialing Rights and Responsibilities​

Fair Hearing Process For Adverse Decisions

 MP CR  9

06/14/2017

Reporting to the Medical Board of California and the National Practitioner Data Bank

 MP CR  9A

10/11/2017

Organizational Providers Assessment Criteria

 MP CR  10

06/14/2017

Delegation of Credentialing and Re-credentialing Activities

 MP CR  11

06/14/2017

Review of Delegated Credentialing and Re-credentialing Policies

 MP CR  11 A

08/09/2017

​​​​​​Delegation Grid Audit Tool​​

Credentialing of Independent Nurses under EPSDT

 MP CR  12

08/09/2017

​​​​Individual Nurse Agreement

Credentialing of Pain Management Specialist

 MP CR  13

02/08/2017

Credentialing of Hospice and Palliative Care Medicine Specialist

 MP CR  13 A

03/08/2017​

​​​​Buprenorphine Prescriber Credentialing

​​MP CR 13 B​​

08/09/2017

Pharmacy Provider Assessment Criteria

 MP CR  14

10/11/2017

Lactation Consultant Credentialing Policy

 MP CR 16

02/08/2017

Standards for Contracted Primary Care Providers

 MP CR  17

10/11/2017

​​​​Primary Care Provider Criteria Form​

Applied Behavioral Health Provider Credentialing Policy

 MP CR  18

08/09/2017

Skilled Nursing Facility Providers (SNFs) Credentialing Policy​​​

​​MP CR 19​

08/09/2017

PHC Provider Contracts

 MP PR  200

08/09/2017

PCP Availability and Capacity Policy and Procedure

 MP PR  201

09/20/2017

Network Availability Standards Policy and Procedure

 MP PR  201 A

11/15/2017​

Monitoring of PHC Specialist Physician Network Availability Policy & Procedure

 MP PR  202

09/20/2017

Reporting of PHC Specialist Physician Network Availability

 MP PR  202 A

11/15/2017

Provider Enrollment Status Guidelines

 MP PR  203

09/13/2017

Monitoring of PCP Accessibility of Services Policy & Procedure

 MP PR  205

09/20/2017

PHC Annual Physician Satisfaction Survey

 MP PR  207

08/09/2017

PHC Provider Termination or Change in Location Information

 MP PR  208

10/11/2017

​​​​Provider Change Form​​​​​

​​​​Provider Contract Termination or Site Closure Form​​​​

Provider Grievance

 MP PR-GR  210

08/09/2017

Access Standards for Substance Abuse Services

 MP PR-SA  212

09/20/2017

Availability of Substance Abuse Clinicians/Outpatient Facilities

 MP PR-SA  213

09/20/2017

​Please Direct Questions To:

Partnership HealthPlan of California
4665 Business Center Drive
Fairfield, CA 94534
Phone: (707) 863-4100