Policy/Procedure Title
Summary of PHC Access and Availability Standards
PHC Provider Directory
Introduction to the Provider Relations Department
Access Standards and Monitoring
Attachment A: Standards for Core Specialists
Wellness & Recovery Access Standards and Monitoring
Credential and Re-credential Decision Making Process
Attachment A: Routine Practitioners List
Ensuring Non-discriminatory Credentialing and Re-credentialing Processes
Attachment A: Non-Discrimination Agreement
Provider Directory Accuracy
Medi-Cal Managed Care Plan Provider Screening and Enrollment
Attachment A: Provider Types and Categories of Risk/Screening Requirements
Attachment B: Managed Care Provider Enrollment Disclosure Background
Credentialing Committee and CMO Credentialing Program Responsibilities
Physician Credentialing and Re-Credentialing Requirements
Attachment A: Original Source Verification Links for Credentials Vetting
Attachment B: Notice of Credentialing Rights and Responsibilities
Non-Physician Clinician Credentialing and Re-Credentialing Requirements
Behavioral Health Practitioner Credentialing and Re-Credentialing Requirements
Applied Behavioral Health Provider Credentialing and Re-Credentialing Requirements
Allied Health Clinician Credentialing and Re-Credentialing Requirements
Provider Credentialing and Re-credentialing Verification Process and Record Security
Attachment A: Credentialing Verification Sources used by Partnership HealthPlan of California for Individual Practitioners
Attachment B.1: Initial Credentialing Checklist
Attachment B.2: Physician Re-Cred Audit Worksheet
Attachment B.3: Non-Physician Clinician Initial Cred Audit Worksheet
Attachment B.4: Non-Physician Clinician Re-Cred Audit Worksheet
Attachment B.5: Allied Health Initial & Re- Cred Audit Worksheet
Attachment B.6: Ancillary Initial & Re- Cred Audit Worksheet
Attachment B.7: Facility Provider Initial & Re- Cred Checklist
Attachment B.8: Long Term Care - Skilled Nursing Facility Provider Initial & Re- Cred Checklist
Attachment B.9: Stand Alone Birth Centers Initial & Re- Cred Checklist
Attachment C: Confidentiality Statement
Identification of HIV/AIDS Specialists
MP CR 4 B
Identification and Notification of HIV/AIDs Specialist Attestation Questionnaire
Ongoing Monitoring and Interventions
Monitoring Resources for Sanctions and Disciplinary Actions
Range of Actions to Improve Practitioner Performance
MP CR 600
Fair Hearing Process for Adverse Decisions
MP CR 601
Reporting Actions to Authorities
MP CR 602
Assessment of Organizational Providers
Attachment A: Credentialing Verification Sources used by Partnership HealthPlan of California for Organizational Providers
Ancillary Care Services Provider Credentialing and Re-credentialing Requirements
Attachment A: Credentialing Verification Sources used by Partnership HealthPlan of California for Ancillary Providers
Attachment B: Non Medical Transportation Attestation
Delegation of Credentialing and Re-credentialing Activities
Credentialing of Community Health Worker(CHW) Supervising Providers
Supervising Provider Attestation for Community Health Workers
Credentialing of Independent and Private Duty Nurses under EPSDT
MP CR 12
Individual Nurse Agreement
Credentialing of Pain Management Specialist
MP CR 13
Credentialing of Hospice and Palliative Care Medicine Specialist
MP CR 13 A
Buprenorphine Prescriber Credentialing
MP CR 13 B
Osteopathic Manipulation Treatment Credentialing
Registered Pharmacists for AB1114 Credentialing
MP CR 13 D
Pharmacy Provider Assessment Criteria
MP CR 14
Doula Credentialing and Re-credentialing Criteria
MP CR 15
Doula Attestation
Lactation Consultant Credentialing Policy
MP CR 16
Standards for Contracted Primary Care Providers
MP CR 17
Primary Care Provider Criteria Form
Example of CME Curriculum for Physicians Trained in Emergency Medicine, who are Seeking to do Primary Care for Children
Skilled Nursing Facility Providers (SNFs) Credentialing Policy
MP CR 19
PHC Provider Contracts
MP PR 200
Provider Enrollment Status Guidelines
MP PR 203
PHC Annual Physician Satisfaction Survey
MP PR 207
PHC Provider Termination or Change in Location Information
MP PR 208
Provider Change Form
Provider Contract Termination Form
Provider Site Closure Form
Provider Network/Subcontractor Contract Terminations and Facility De-certifications and Suspensions
Provider Grievance
MP PR-GR 210
Please Direct Questions To:
Partnership HealthPlan of California4665 Business Center DriveFairfield, CA 94534Phone: (707) 863-4100
