ແຈ້ງ​ການ​ຂໍ້​ມູນ​ຂ່າວ​ສານ​ສຸ​ຂະ​ພາບ​ພຶດ​ຕິ​ກໍາ​ແລະ​ຕົວ​ອັກ​ສອນ​​ 

10-04: MHP Self-certification Letter.pdf​​ 

ແບບຟອມການຢັ້ງຢືນ​​ 

ແບບຟອມສົ່ງຜ່ານໃບຢັ້ງຢືນ Medi-Cal DHCS 1735​​  | ວິດີໂອການຝຶກອົບຮົມ​​ 
ຈຸດ​ປະ​ສົງ​ຂອງ​ການ​ສົ່ງ​ຕໍ່​ແມ່ນ​ເພື່ອ​ຮ້ອງ​ຂໍ​ການ​ເຮັດ​ທຸ​ລະ​ກໍາ​ດັ່ງ​ຕໍ່​ໄປ​ນີ້​:​​ 

County-owned and operated provider – activate mode(s) or service, termination of a mode(s) or all services, address change and name change.​​ 

Contracted provider – activate a new provider, activate a mode(s) of service, and terminate mode(s) or all services, recertification, address change and name change.​​ 

ແບບຟອມຄໍາຮ້ອງການຢັ້ງຢືນ DHCS 1736 County-ເປັນເຈົ້າຂອງ ແລະດໍາເນີນການ​​  | ວິດີໂອການຝຶກອົບຮົມ​​ 
The purpose of the form is for the County to submit an application for a new county-owned and operated provider.
DHCS 1737 County-Owned and Operated Provider Self-Survey Form | Training Video
The purpose of the Self-Survey Form is for the recertification of a county-owned and operated provider.​​ 

ຊັບ​ພະ​ຍາ​ກອນ​​ 

• ສັນຍາແຜນສຸຂະພາບຈິດ​​ 
• ຫນ້າທໍາອິດການກວດສອບແລະການສືບສວນ​​ 

ຂໍ້​ມູນ​ຕິດ​ຕໍ່​​ 

ພະແນກທົບທວນສັນຍາ ແລະ ການລົງທະບຽນ (CERD)
ກົມບໍລິການດ້ານສຸຂະພາບ
1500 Capitol Avenue, MS 2303
ຕູ້ໄປສະນີ 997413
Sacramento, CA 95899-7413

ອີເມວ: DMHCertification@dhcs.ca.gov​​