Flowchart Process Summary
DMH Short Doyle Claims Flow Chart
FFPDMH Cost and Financial Reporting System (CFRS)-Cost Reporting and Settlement Processes
DMH Cost and Financial Reporting System (CFRS)-Initial Submission Process
DMH Cost and Financial Reporting System (CFRS)-Cost Report Settlment Process
DMH Procedure For Establishing A Disproportionate Share Hospital (DSH) In the Provider Master File At DHCS
DMH Psychiatric Inpatient Hospital Rate Setting Process Administrative Day Rates
Statewide Maximum Allowance (SMA) Rate Setting Process
Specialty Mental Health - Data Management and Analysis Section (DMAS) - Business Practices and Procedures
DMH Data Management & Analysis Section Medi-Cal Workflow Analysis
Additional Details Relating To Certain Systems/Reports
Acronyms, Definitions, and Legend (Medi-Cal Oversight [MCO])
Exhibit I - Protocol Development (MCO)
Exhibit II – System Review and Outpatient Chart Reviews and Appeals (MCO)
Exhibit III – EPSDT Chart Reviews and Appeal Process (MCO)
Exhibit III A – EPSDT Chart Reviews and Appeal Process (MCO)
Exhibit IV – Inpatient Chart Reviews and Appeals (MCO)
Exhibit V – Certification/Re-certification Reviews (MCO)
Exhibit VI – TAR Appeals and Lawsuits (MCO)
Exhibit VII – Professional Licensing Waiver (MCO)
Exhibit VIII – Questionable Medical Billing (MCO)
Exhibit IX – Contracts (MCO)
Specialty Mental Health Annual External Quality Review Organization (EQRO) Process
Specialty Mental Health Services State Plan Amendment (SPA) Process
Specialty Mental Health Services Section 1915(b) Waiver Renewal Process
Specialty Mental Health Services Waiver Cost Effectiveness Process
Specialty Mental Health Preadmission Screening and Resident Review (PASRR) Process
DMH Specialty Mental Health Services Short-Doyle/Medi-Cal (SD/MC) Provider Enrollment Process
DMH County Technical Assistance Process
Specialty Mental Health Services Program Budget Estimation Process