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Drug Medi-Cal Organized Delivery System

Welcome to the County of San Diego’s Behavioral Health Services (BHS) Drug Medi-Cal Organized Delivery System (DMC-ODS) document library. From this site you will be able to access any communications, forms, and manuals that BHS has sent out to providers. If you are looking for more general information regarding DMC-ODS, please visit the BHS DMC-ODS website by clicking here.  

Training

If you are provider and are looking for a comprehensive list of required provider trainings for DMC-ODS, click here to visit the DMC-ODS Training site.

If you have questions regarding Training for SanWITS, a tips and resources page is now available for providers and Program Managers.

SUDPOH
1 – SUDPOH (pdf)
Revised 03/20/2023 2023-03-22
2 – Summary of Changes (pdf)
Revised 03/20/2023 2023-03-22

SUDURM
602a_Instructions_SUD_Peer_Plan_of_Care_Progress_Note_08-2022.pdf
2022-08-18
00 – SUD Uniform Record Manual 07-01-19 (pdf)
2019-09-03
01 – Uniform Record Manual 07-01-19 (pdf)
Revised July 2019 2019-07-31
02 - Client File Order (pdf)
Revised December 2020 2020-12-23
03 - Section 1 Detail 01-14-19 (pdf)
2019-02-11
101a Instruction Client Tracking (pdf)
Revised December 2020 2020-12-23
101b Client Tracking (pdf)
Revised December 2020 2020-12-23
103 Instruction Medi-Cal Eligibility Printout (pdf)
2019-02-11
104a Instruction Supplement Minor Children 04-12-17 (pdf)
2018-01-24
104a Minor Children Form 04-12-17 (pdf)
2018-01-24
104b-1 Instructions Brief Screening Tool (pdf)
Revised August 2022 2022-08-12
104b-2 Brief Level of Care Screening Tool (pdf)
Revised August 2022 2022-08-12
104d-1 Instructions Adolescent Initial Level of Care Assessment (pdf)
Revised 09/2022 2022-10-10
104d-2 Adolescent Initial LOC Assessment Hard Copy (pdf)
2022-10-10
104d-3 Adolescent Initial LOC Assessment Form (pdf)
Revised December 2020 2021-02-10
104e-1 Instructions Parent Guardian Initial Level of Care Assessment (pdf)
Revised December 2020 2020-12-23
104e-2 Parent Guardian Initial LOC Assessment Hard Copy (pdf)
Revised December 2020 2020-12-23
104e-3 Parent Guardian Initial LOC Assessment Form Fill (pdf)
Revised December 2020 2020-12-23
105 Placement Fee Collection 4-12-17 (pdf)
2017-05-01
105a Instructions Adult ASAM Criteria Assessment (pdf)
Revised August 2022 2022-08-12
105b ASAM Criteria Assessment (pdf)
August 2022 2023-03-07
106 Placement-ID-SS-Medi Cal Cards (pdf)
2018-07-06
107a Instruction Financial Responsibility Info and MC SOC 05-01-2020 (pdf)
Revised May 2020 2020-05-14
107b Financial Responsibility Information and MC SOC 05-01-2020 (pdf)
Revised May 2020 2020-05-14
108 Placement - SanWITS Admission Profile 01-14-19 (pdf)
2019-02-11
200 Section 2 Detail 07-01-19 (pdf)
2019-07-26
201 Placement-consent to release 07-01-19 (pdf)
2019-07-26
202 Placement-Admissions Agreement-Consent to Treatment 4-12-17 (pdf)
2017-05-01
203a Instructions Client Rights and Complaints 05-01-2020 (pdf)
Revised May 2020 2020-05-14
203b Client Rights and Complaints (pdf)
Revised December 2020 2020-12-23
204 Placement-42 CFR Written Summary Requirements 7-2-18 (pdf)
2018-07-06
205 Placement-Notice of Privacy-HIPAA 4-12-17 (pdf)
2017-05-01
206 Placement-Consent to Follow up 4-12-17 (pdf)
2017-05-01
207 Placement-Consent for photo-tv-video 4-12-17 (pdf)
2017-05-01
209a Instruction Acknowledgement of DMC-ODS Handbook Practice Guidelines and Provider Directory 03-07-19 (pdf)
2019-03-21
209b Acknowledgement of DMC-ODS Handbook Practice Guidelines and Provider Directory (pdf)
2021-02-09
210a Instructions SUD Program Admission Checklist 6-27-18 (pdf)
2018-07-06
210b SUD Program Admission Checklist (pdf)
Revised November 2022 2022-11-11
300 Section 3 Detail 7-3-18 (pdf)
2018-07-06
302a Instruction Alcohol and Drug Hx 4-12-17 (pdf)
2017-05-01
302b Alcohol and Drug History Form 4-12-17 (pdf)
2017-05-01
303a Instruction ASI-YAI 01-11-19 (pdf)
2019-02-11
303d YAI (pdf)
2018-09-11
304a Instruction Co-occurring Form 4-12-17 (pdf)
2017-05-01
304b Co-occurring Screening Form 4-12-17 (pdf)
2017-04-27
304c Form Fill Co-occurring Screening Form 4-12-17 (doc)
2017-04-27
305a-1 Instruction Risk Assessment and Safety Management Plan 06-06-19 (pdf)
Revised 06-06-19 2019-07-22
305a-2 Risk Assessment and Safety Management Plan 06-06-19 (pdf)
2019-07-22
305b-1 Instruction High Risk Assessment 06-06-19 (pdf)
Revised 06-06-19 2019-07-22
305b-2 High Risk Assessment 06-06-19 (pdf)
2019-07-22
307a Instructions Assessment Summary 01-11-19 (pdf)
2019-02-11
307b Assessment Summary 06-26-18 (pdf)
2018-07-06
307c Assessment Summary Form Fill 06-26-18 (pdf)
2018-07-06
400 Section 4 Detail 01-14-19 (pdf)
2019-02-11
401a Instruction WM Observation Log 11-26-19 (pdf)
2019-12-02
401b Withdrawal Observation Log 11-21-19 (pdf)
2019-12-02
402a Instruction Centrally Stored Medication & Destruction Record 4-12-17 (pdf)
2018-07-06
402b Centrally Stored Medication and Destruction Record (pdf)
2017-04-27
403 Placement – Health Questionnaire 07-07-2022 (pdf)
2022-08-02
404a Instruction TB questionnaire 01-11-19 (pdf)
2019-02-11
404b TB screening form 4-12-17 (pdf)
2017-05-01
406 Instruction Physician Direction Form (pdf)
Revised 2022 2022-10-10
406 Physician Direction Form 09-2022 (pdf)
Revised 09/2022 2022-10-10
407 MD Recomendation to client 4-12-17 (pdf)
2017-05-01
407a Placement - Physical Exam Results 05-01-2020 (pdf)
Revised May 2020 2020-05-14
408 Placement - Proof of Pregnancy 01-11-19 (pdf)
2019-02-11
500 Section 5 Detail 01-14-19 (pdf)
2019-02-11
501a Instructions Problem List (pdf)
Revised August 2022 2022-08-12
501b Problem List (pdf)
Revised August 2022 2022-08-12
505a Instructions Treatment Effectiveness Assessment 01-09-19 (pdf)
2019-02-11
505b Treatment Effectiveness Assessment 01-09-19 (pdf)
2019-02-11
600 Section 6 Detail 01-15-19 (pdf)
2019-02-11
601a Instructions SUD Treatment Progress Note (pdf)
Revised August 2022 2022-08-12
601b SUD Treatment Progress Note 08-2022 (pdf)
Revised August 2022 2022-09-22
602b Peer Support Services Plan of Care (pdf)
Revised 08/2022 2022-09-19
605a Instructions Other Progress Note (pdf)
Revised December 2020 2020-12-23
605b Other Progress Note (pdf)
Revised December 2020 2020-12-23
605c Other Progress Note - Form Fill 12-01-2020 (pdf)
Revised December 2020 2021-01-28
700 Section 7 Detail 01-15-19 (pdf)
2019-02-11
701a Instructions Discharge Summary (pdf)
Revised October 2021 2021-11-03
701b Discharge Summary - Hard Copy (pdf)
Revised October 2021 2021-11-03
701c Discharge Summary - Form Fill (pdf)
Revised October 2021 2021-11-03
703 Placement - SanWITS Discharge Profile 01-14-19 (pdf)
2019-02-11
704a Instruction Client Discharge Plan (pdf)
Revised October 2021 2021-11-03
704b Client Discharge Plan - Hard Copy (pdf)
Revised October 2021 2021-11-03
704c Client Discharge Plan - Form Fill (pdf)
Revised October 2021 2021-11-03
800 Section 8 Detail 01-15-19 (pdf)
2019-02-11
801a Instruction Drug Test and Results Log 01-11-19 (pdf)
2019-02-11
801b Drug Test and Result Log Form (pdf)
2017-05-01
802 placement Drug Test Results From Lab 4-12-17 (pdf)
2017-05-01
803 placement Progress Reports (pdf)
2017-05-01
805 placement Referral Source Documents (pdf)
2017-05-01
807 Placement - SanWITS Residential Authorization Printout (pdf)
2019-02-11
ADOLESCENT RSUD AUTH REQUEST FAX COVER SHEET (docx)
Revised 09/01/2022 2022-09-02
ADOLESCENT RSUD AUTH REQUEST FAX COVER SHEET (pdf)
Revised 09/01/2022 2022-09-02
ADULT RSUD AUTH REQUEST FAX COVER SHEET (docx)
Revised 09/01/2022 2022-09-02
ADULT RSUD AUTH REQUEST FAX COVER SHEET (pdf)
Revised 09/01/2022 2022-09-02
SUD Residential Authorization Request (pdf)
Revised 09/01/2022 2022-09-02
SUD Residential Authorization Request (pdf)
Revised 09/01/2022 2022-09-02

Forms
BHS Inventory Form (xlsx)
2021-06-24
DPC 203 and 204 Forms (docx)
2023-02-07
Gift Card Approval Form (xlsx)
2021-06-24
PWD Accessibility Assessment (docx)
2022-11-08
PWD Program Referral List (pdf)
Updated 9/30/2021 2022-11-08
Root Cause Analysis Worksheet (doc)
2021-06-24
SUD Complaint Form (docx)
2021-06-24
Serious Incident Report (docx)
Revised 10/27/2022 2022-11-02
Serious Incident Report - Explanation (pdf)
2022-07-07
Serious Incident Report of Findings (docx)
Revised 07/07/2022 2022-07-12
Serious Incident Report of Findings Explanation (pdf)
2022-07-14

Communications
Info Notice – Payment Reform CPT Crosswalk (pdf)
May 15, 2023 2023-05-31
Info Notice – Open Payments Database (pdf)
05/04/2023 2023-05-19
Out-of-Network Claims Process for Indian Health Care Providers (pdf)
Revised 04/03/2023 2023-04-11
Residential OOC Medi-Cal Tip Sheet (pdf)
Revised 03/20/2023 2023-03-23
Outpatient OOC Medi-Cal Tip Sheet (pdf)
Revised 03/20/2023 2023-03-23
OTP OOC Medi-Cal Tip Sheet (pdf)
Revised 03/20/2023 2023-03-23
BHS Info Notice-DMC Process for Out-of-County Clients (pdf)
03/22/2023 2023-03-23
DMC Flowchart for Out-of-County Clients (pdf)
03/20/2023 2023-03-23
BHS and Probation Care Coordination Directive (pdf)
Revised 02/08/2023 2023-02-16
Info Notice – Documentation Reform Implementation Update (pdf)
Revised 08/15/2022 2022-08-18
00 – Archived List – Communications (pdf)
Revised 10/06/2022 2022-10-12
CYF Memo – DMC-ODS Updated Guidance for TRC Sites (pdf)
January 18, 2019 2022-10-06
Info Notice – CalAIM Documentation Reform BHS Plan
6/14/22 2022-06-24
Info Notice – New Program Enrollment – Before Admission/After Discharge (pdf)
6/23/22 2022-06-24
ACO Tip Sheet – 42 CFR Changes (pdf)
Effective 08/14/2020 2021-06-24
01 - Compliance Bulletin #30 - Cloned Documentation - 11-1017 (pdf)
2011 10/17 Issued 2018-12-06
System of Care (SOC) Application - (BHS) – Contractor Information Notice (pdf)
11/23/2020 2020-11-30
DHCS Medi-Cal Rx Website and Pharmacy Portal Policy (pdf)
08/14/2020 2020-10-22
DHCS Medi-Cal Rx FAQ (pdf)
06/30/2020 2020-10-22
Info Notice - Medi-Cal Rx Prescriber and Pharmacy Provider Registration and Training (pdf)
10/21/2020 2020-10-22
QM Memo – State Fair Hearing COVID Waiver (pdf)
04/16/2020 2020-05-12
3/19/20 BHS Provider Notice #3- COVID 19- Quality Improvement Updates and Best Practices (pdf)
2020-03-20
QM Memo – DSM 5 Diagnoses in SanWITS (pdf)
Issued 01/22/2020 2020-01-27
Info Notice – BHS 2020-002 - DMC-ODS Clients with Other Health Coverage (pdf)
Issued 01/15/2020 2020-01-16
Info Notice - BHS 2020-002 Assign Insurance Benefits Form (pdf)
Revised 05/20/2019 2020-01-16
Memo – DMC-ODS Travel Time Guidelines (pdf)
Updated 10-21-19 2019-10-22
Email – SUD Providers – Requirements for Policy and Procedure Development Monitoring (pdf)
2018 02/23 Emailed 2019-10-10
QM Memo - Physical Exam Requirements (pdf)
2019 10/02 Issued 2019-10-03
QM Memo - Residential Authorization Request Timelines
2019 08/05 Issued 2019-08-12
Info Notice - DMC-ODS FY 18-19 Data Entry Requirements
06/28/2019 2019-07-18
Info Notice – Share of Cost Process (pdf)
2019 02/01 Issued 2019-02-06
Memo – Patient Advocacy Services for BHS – Record Requests (pdf)
2018 10/31 Emailed 2018-11-02
Memo – Assessed No Admit and Assess Delayed Admit 10-18 (pdf)
2018 10/19 Issued 2018-10-26
Info Notice – BHS 2018-014 Timely Admissions for Collaborative Court Participants (pdf)
2018 10/19 Issued 2018-10-26
Email - BHS 2018-014: Timely Admissions for Collaborative Court Participants (pdf)
2018 10/12 Emailed 2018-10-19
Info Notice - Timely Access to Services (pdf)
2018 07/31 Issued 2018-08-06
Info Notice - Process for Out-of-County Clients (pdf)
2018 07/30 Issued 2018-08-06
Info_Notice_-_Reentry_and_Drug_Courts_SUD_Treatment_Services.pdf
2018 06/13 Issued 2018-06-15
Info_Notice_-_DMC-ODS_Court_Ordered_Residential_Treatment_-_Follow-Up.pdf
2018 06/12 Issued 2018-06-12
Info_Notice_-_DMC-ODS_Training_Requirements_and_Waiver_Resources.pdf
2018 03/19 Issued 2018-06-06
Info_Notice_-_DMC-ODS_Court_Ordered_Residential_Treatment.pdf
2018 05/17 Issued 2018-06-06

QM Training
00 - Archived List - QM Training (pdf)
Updated 09/01/2022 2022-09-02
01 – Annual DMC-ODS Training (pdf)
Revised 08/18/2022 2022-10-06
06 - DMC-ODS New Training Requirements FY 22-23 (pdf)
2022-10-21
02 – Program Integrity Webinar (pdf)
Revised April 2021 2023-05-11
03 – Beneficiary Rights Webinar (pdf)
Revised 06/04/2019 2023-05-11
04 – Substance Use Disorder PRIVACY RULES 2022
2022-02-22
05 – CalMHSA Learning Management System Instructions (pdf)
2022-07-20
07 – How to Access RIHS Trainings (pdf)
2022-11-08

Manuals
County of San Diego DMC-ODS Implementation Plan.pdf
2018-09-13
County of San Diego DMC-ODS Implentation Plan Appendix.pdf
2018-09-13
00 – Archived List - Manuals (pdf)
Updated 06/30/2021 2021-07-02
00 – Archived List – Manuals (pdf)
Updated 05/09/2024 2024-05-09
CalMHSA Clinical Documentation Manual (pdf)
Revised 06/03/2022 2022-06-10
County of San Diego DMC-ODS Intergovernmental Agreement FY 2020-2023 (pdf)
2021-06-29
County of San Diego DMC-ODS Intergovernmental Agreement FY 2023-2027 (pdf)
2024-05-09
DHCS AOD Program Certification Standards (pdf)
February 2020 2020-08-26
DHCS Adolescent SUD Best Practices Guide (pdf)
October 2020 2022-08-02
DHCS Perinatal Practice Guidelines (pdf)
2020-07-17
DMC - ODS Provider Services Guide
Updated 10/26/2020 2020-11-03
DMC - ODS Provider Services Guide (Summary of Changes)
October 2020 2020-11-03
SABG Enclosure 2 Program Specifications (pdf)
2022-02-09
Special Terms and Conditions (pdf)
Amended 12/29/2020 2021-05-21

Toolbox
One-Pager_-_DMC-ODS_Required_Policies_and_Procedures.pdf
Updated Jun 8 2018 2018-06-12
One-Pager_-_Programs_with_Multiple_Contracts.pdf
Updated May 14 2018 2018-06-15
Group Participation List (pdf)
Updated 09/2023 2023-04-20
00 – Archived List – Toolbox (pdf)
Revised 03/08/2022 2022-03-09
ASAM Level of Care Guidelines (pdf)
2018-11-08
CDC Effects of Tobacco on Mental Health and Substance Use
2022-07-21
CPT Crosswalk for DMC-ODS (xlsb)
Revised 05/15/2023 2023-05-19
CRAFFT Questionnaire (TRC Only) (pdf)
2021-07-29
DHCS Toolkit – MAT in Residential Treatment Facilities (pdf)
2020-09-21
DMC-ODS SUD Provider Operations Resource Guide (pdf)
Updated December 2020 2020-12-16
Diagnosis Determination Tool (pdf)
Revised 09/2022 2023-01-27
IHCP Referral Resource (pdf)
2023-04-21
In-custody SUD Tx Self-Referral form 10-16-18 (pdf)
2018-10-26
MAT Education
Uploaded 06/08/2021 2021-06-08
One-Pager DMC-ODS Documentation Changes (pdf)
Updated Jun 18 2018 2018-06-20
One-Pager – Care Coordination in the DMC-ODS (pdf)
September 14, 2022 2022-10-26
One-Pager – Tobacco Cessation Resources
2022-07-21
Opioid Treatment Program Guidelines (pdf)
Updated 05/14/2021 2021-05-21
Outpatient Due Date Timelines – Leap Year (pdf)
2022-12-13
Outpatient Due Date Timelines – Standard Year (pdf)
2022-12-13
Priority SDOH Codes on Problem Lists (pdf)
2022-08-02
Quick Guide - DMC-ODS Client Flow Process (pdf)
2018-09-10
Quick Guide - Residential Due Dates (pdf)
2018-08-10
Quick Guide - Same Day Billing Matrix (pdf)
Updated Jun 19 2018 2018-06-22
Quick Guide – Care Coordination Activities (pdf)
September 2022 2022-10-26
Quick Guide – DSM5-ICD10 Diagnosis Guide (pdf)
Updated 10/20/22 2022-11-08
Quick Guide – EPSDT 0.5 Workflow (pdf)
2023-02-03
Quick Guide – Minimum Quality Drug Treatment Standards for DMC/SABG (pdf)
2022-10-26
Quick Guide – Residential Services (pdf)
Updated 10/27/2022 2023-02-14
Quick Guide – SUD Residential Clinical Documentation and Authorization (pdf)
Revised September 2022 2022-10-26
RS Enrollment in a Different Program (pdf)
09/09/2022 2022-09-14
RS Enrollment with No Prior Enrollment (pdf)
09/09/2022 2022-09-14
RS Enrollment within the Same Program (pdf)
09/09/2022 2022-09-14
Residential Due Date Timelines – Leap Year (pdf)
2022-12-13
Residential Due Date Timelines – Standard Year (pdf)
2022-12-13
Residential Due Date Timelines – Standard Year Immediately Preceding Leap Year (pdf)
2022-12-13
Residential Weekly Services Log Tool (pdf)
Revised 09/2022 2023-01-27
Transportation Guidelines (pdf)
Updated 10-25-19 2019-10-28
Withdrawal Management Standards (pdf)
Revised 06/04/2020 2020-11-25

Beneficiary
DMC-ODS Beneficiary Handbook - English (pdf)
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Spanish.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Vietnamese.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Tagalog.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Farsi.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Korean.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Dari.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Chinese (Trad).pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Somali.pdf
Effective 03/12/2023 2023-03-10
DMC-ODS Beneficiary Handbook February 2023_Arabic.pdf
Effective 03/12/2023 2023-03-10
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Arabic.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__English.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Farsi.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Spanish.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Tagalog.mp3
For use after Jul 1 2018 2018-06-20
Audio__Quick__Guide__-__DMC-ODS__Services__in__San__Diego__-__Vietnamese.mp3
For use after Jul 1 2018 2018-06-20
Brochure_-_Grievance_and_Appeal_Process_-_English.pdf
For use after Jul 1 2018 2018-06-29
02 – DMC-ODS Beneficiary Handbook Summary of Changes (pdf)
Revised 02/06/2023 2023-02-07
00 – Archived List – Beneficiary (pdf)
February 9, 2021 2021-02-10
01 - DMC-ODS Beneficiary Packet Materials Order Form 05-09-19 (pdf)
2019-05-13
Advance Directive - Dari (pdf)
2023-05-04
Advance Directive - Farsi (pdf)
2023-05-04
Advance Directive - Korean (pdf)
2023-05-04
Advance Directive – Arabic (pdf)
2023-05-04
Advance Directive – Chinese (Traditional) (pdf)
2023-05-04
Advance Directive – English (pdf)
2023-05-04
Advance Directive – Somali (pdf)
2023-05-04
Advance Directive – Spanish (pdf)
2023-05-04
Advance Directive – Tagalog (pdf)
2023-05-04
Advance Directive – Vietnamese (pdf)
2023-05-04
Brochure – Grievance and Appeal Process 6-28-18 Arabic (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Farsi (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Spanish (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Tagalog (pdf)
2018-08-15
Brochure – Grievance and Appeal Process 6-28-18 Vietnamese (pdf)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Arabic (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 English (docx)
2018-06-29
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Farsi (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Spanish (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Tagalog (docx)
2018-08-15
Form – Client Grievance or Appeal – CCHEA Outpatient 6-28-18 Vietnamese (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Arabic (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 English (docx)
For use after Jul 1 2018 2018-06-29
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Farsi (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Spanish (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Tagalog (docx)
2018-08-15
Form – Client Grievance or Appeal – JFS Residential 6-28-18 Vietnamese (docx)
2018-08-15
Limited English Proficiency Poster – Arabic (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Chinese (Traditional)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Dari (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – English (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Farsi (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Korean (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Somali (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Spanish (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Tagalog (pdf)
Revised 04/2023 2023-05-02
Limited English Proficiency Poster – Vietnamese (pdf)
Revised 04/2023 2023-05-02
Open Payments Database Notification to Clients (pdf)
2023-05-26
Poster – Grievance and Appeal 03-06-19 Arabic (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 English (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Farsi (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Spanish (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Tagalog (pdf)
2020-03-12
Poster – Grievance and Appeal 03-06-19 Vietnamese (pdf)
2020-03-12
Poster – Grievance and Appeal English LARGE FONT 03-05-19 (pdf)
2020-03-12
Quick Guide - How To Apply for Medi-Cal (pdf)
2018-11-27
Quick Guide – DMC-ODS Services in San Diego - Arabic (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - English (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Farsi (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Spanish (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Tagalog (pdf)
Updated 03-04-2019 2019-03-05
Quick Guide – DMC-ODS Services in San Diego - Vietnamese (pdf)
Updated 03-04-2019 2019-03-05

NOABD
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Modification_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ENGLISH.docx
- 2018-08-07
NOABD_Timely_Access_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_TAGALOG.docx
- 2018-08-07
Notice_of_Grievance_Resolution_-_ARABIC.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Denial_Notice_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_TAGALOG.docx
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_SPANISH.pdf
2018-08-06
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Modification_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_ARABIC.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_FARSI.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.pdf
- 2018-08-07
NOABD_Denial_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Termination_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_FARSI.pdf
- 2018-08-07
NOABD_Modification_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ARABIC.docx
- 2018-08-07
Notice_of_Grievance_Resolution_-_TAGALOG.docx
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.pdf
- 2018-08-07
NOABD_Modification_Notice_-_FARSI.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.doc
2018-08-06
NAR_Your_Rights_State_Hearing_-_SPANISH.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Denial_Notice_-_SPANISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.docx
2018-08-06
NOABD_Your_Rights_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_VIETNAMESE.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.pdf
- 2018-08-07
Notice_of_Grievance_Resolution_-_ENGLISH.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_SPANISH.pdf
- 2018-08-07
NOABD_Financial_Liability_Notice_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_ENGLISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.pdf
- 2018-08-07
Notice_of_Grievance_Resolution_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Denial_Notice_ENGLISH.doc
2020-06-12
Beneficiary_Non-Discrimination_Notice_-_FARSI.pdf
2018-08-06
NAR_Your_Rights_State_Hearing_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_FARSI.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.pdf
2018-08-06
NAR_Your_Rights_State_Hearing_-_SPANISH.pdf
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_SPANISH.docx
2020-06-12
NOABD_Termination_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Termination_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Termination_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Termination_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_VIETNAMESE.docx
- 2018-08-07
NOABD_Modification_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Modification_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Financial_Liability_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_ENGLISH.pdf
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_TAGALOG.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_ARABIC.pdf
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Denial_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ENGLISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_FARSI.doc
2018-08-06
NOABD_Payment_Denial_Notice_-_FARSI.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_SPANISH.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ARABIC.pdf
2018-08-06
NOABD_Denial_Notice_-_ARABIC.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.pdf
2018-08-06
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Termination_Notice_-_FARSI.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_SPANISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_ARABIC.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ENGLISH.doc
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_ENGLISH.pdf
2018-08-07
Notice_of_Adverse_Benefit_Determination_(NOABD)_Notices (pdf)
Revised 01/08/2020 2021-04-21

UTTM

For versions of the UTTM prior to September 2018, please see the “UTTM” tab on the Organizational Provider Public Documents page.
SUD Up to the Minute – May 2023 (pdf)
2022 - 2023 2023-05-23
SUD Up to the Minute – April 2023 (pdf)
2022 - 2023 2023-04-13
SUD Up to the Minute – March 2023 (pdf)
2022 - 2023 2023-04-13
SUD Up to the Minute – February 2023 (pdf)
2022 - 2023 2023-02-10
SUD Up to the Minute – January 2023 (pdf)
2022 - 2023 2023-01-13
SUD Up to the Minute – December 2022 (pdf)
2022 - 2023 2022-12-13
SUD Up to the Minute – November 2022 (pdf)
2022 - 2023 2022-11-11
SUD Up to the Minute - October 2022 (pdf)
2022 - 2023 2022-10-19
SUD Up to the Minute - September 2022 (pdf)
2022 - 2023 2022-09-09
SUD Up to the Minute - August 2022 (pdf)
2022 - 2023 2022-08-12
SUD Up to the Minute - July 2022 (pdf)
2022 - 2023 2022-07-20
FY21-22 Combined (pdf)
2022-09-08
FY20-21 Combined (pdf)
2022-01-07
FY19-20 Combined (pdf)
2022-01-07
FY18-19 Combined (pdf)
2022-01-07

SanWITS
Contingency Management Incentive Program (pdf)
Tip Sheet – Contingency Management Incentive Program 05/02/2023 2023-06-06
SanWITS_Users_Group_April_17,_2023.pdf
Presentation 04.17.23 2023-04-24
Tip Sheet 3-38 OOC Claim Details Report (pdf)
Tip Sheet 2023-04-12
Tip Sheet 3-37 OOC Claim Summary Report (pdf)
Tip Sheet 2023-04-12
SanWITS BHS County and Optum Staff User Form (pdf)
Revised 03/29/2023 2023-03-30
SanWITS Report Request Form (docx)
Revised 03/01/2023 2023-03-16
SanWITS User Modification Termination Form (pdf)
Revised 03/10/2023 2023-03-14
SanWITS New User Form (pdf)
Revised 03/10/2023 2023-03-14
Encounter Date Outside Program Enrollment Date Range (pdf)
Encounter Audit Findings 02/15/2023 2023-02-16
SanWITS Users Group Jan 23, 2023 (pdf)
Presentation 01/23/2023 2023-01-24
Memo - SanWITS DMC-ODS Data Entry Standards (pdf)
Revised 10/20/2022 2022-10-27
Tip Sheet NOABD Notice of Adverse Benefit Determination Notice (pdf)
Revised 10/20/2022 2022-10-27
SanWITS Users Group Oct 17, 2022 (pdf)
Presentation 2022-10-18
Tip Sheet - Early Intervention Service Program Enrollment (pdf)
Tip Sheet 09/22/2022 2022-09-22
Email –SanWITS Start and End Time No Longer Required (pdf)
Email 09/15/2022 2022-09-16
Email – SanWITS Notice – Delayed Admission Program Enrollment being Removed (pdf)
Email 09/15/2022 2022-09-16
SanWITS Users Group Jul 18, 2022 (pdf)
07/18/2022 2022-08-05
Tip Sheet: Courtesy Dosage Program Enrollment in SanWITS (pdf)
Revised 07/15/2022 2022-07-19
Tip Sheet - Before Admission After Discharge Program Enrollment (pdf)
Revised 06/22/2022 2022-06-22
SanWITS Users Group Jan 24, 2022 (pdf)
2022-05-12
SanWITS Users Group Apr 18, 2022 (pdf)
2022-05-12
Tip Sheet - New TUOS Detail Claim Report (pdf)
05/01/2022 2022-04-07
Tip Sheet - New TUOS Summary Report (pdf)
05/01/2022 2022-04-07
Tip Sheet – Recovery Residence Tracking (pdf)
Revised 1/27/2022 2022-01-28
SanWITS - Creating Diagnosis through Diagnostic Determination Notes DDN (pdf)
Revised 01/20/2022 2022-01-20
SanWITS - Telehealth and Telephone Service Encounter Tip Sheet (pdf)
Revised 12/16/2021 2021-12-16
SanWITS Users Group Oct 18, 2021 (pdf)
Presented: 10/18/2021 2021-10-27
Tip Sheet - Document Storage (pdf)
Revised 10/21/2021 2021-10-26
SanWITS Document Storage – Approved Documents for Attachment (pdf)
Revised 10/09/2021 2021-10-26
Special Notice regarding EHR Dual Entry (msg)
Email 2021-08-04
SanWITS Usesrs Group Jul 19 2021 (msg)
Email 2021-08-04
FW Important Notice - DATAR Capacity Reporting (msg)
Email 2021-08-04
Tip Sheet - Recovery Services (pdf)
Revised 07/19/2021 2021-07-22
Tip Sheet - Additional MAT - Split Dosing (pdf)
Tip Sheet - Revised 02/03/2021 2021-02-03
Tip Sheet - SanWITS EHR Readiness (pdf)
Revised 12/11/2020 2020-12-11
Basic Computer Skills Quiz (pdf)
Revised 12/11/2020 2020-12-11
Tip Sheet: Non-BHS Contracted Client Program Enrollment / CalOMS_Reporting (pdf)
Tip sheet 2020-10-28
SanWITS Billing Enhancements 20.4.5 (pdf)
Enhancements 2020-10-08
SanWITS Screen Enhancements 20.4.5 (pdf)
Enhancements 2020-10-08
Tip Sheet – OTP Reimbursement Rates Clarification (pdf)
Revised 9/23/20 2020-09-23
Tip Sheet - DSM 5 Diagnostic Labels in SanWITS (pdf)
Revised 9/21/20 2020-09-22
Tip Sheet – Drug Court Programs Workflow (pdf)
Revised 06/24/20 2020-06-25
SanWITS Flow Chart for Encounters Released to Bill and Placed on Hold (pdf)
Created 5/27/20 2020-06-15
SanWITS Flow – Group List for Outpatient Providers (pdf)
Revised 6/11/20 2020-06-12
DHCS Application Portal User Manual (pdf)
2020-04-21
DATAR Rewrite User Manual (pdf)
2020-04-21
Tip Sheet – Services provided via Telehealth (pdf)
Created 3/20/20 2020-03-25
Tip Sheet – Changing Level of Care (pdf)
Email 2020-03-06
Tip Sheet - Steps for Disallowed Services (pdf)
Created 08/23/2019 2020-02-06
Forms - CalOMS Profile S108A and S108B (pdf)
2019-12-12
Forms - CalOMS Annual Update S112 (pdf)
2019-12-12
Forms - CalOMS Admission S111 (pdf)
2019-12-12
Forms - CalOMS Discharge S703 (pdf)
2019-12-12
Forms - SanWITS Encounter S113 (pdf)
2019-12-12
Forms - SanWITS Intake S110 (pdf)
2019-12-12
Forms - SanWITS Contact S109 (pdf)
2019-12-12
CalOMS Tx Data Dictionary April 2018 (pdf)
2019-12-11
Tip Sheet - Residential Service Claims and Payor Group Enrollment (pdf)
Updated 05/30/2019 2019-08-05
Tip Sheet - Outpatient Service Claims and Payor Group Enrollment (pdf)
Updated 05/30/2019 2019-08-05
SanWITS SSRS Tip Sheet Run Reports (pdf)
2019-06-21
Service Claims and Payor Group Enrollment New Procedure (pdf)
MIS Informational Notice 2019-05-01
SanWITS Flow for Opioid Treatment Providers
2019-02-07
SanWITS Flow – Group List for Outpatient Providers (pdf)
2019-02-07
SanWITS Flow – Group List for OTP Providers (pdf)
2018-11-02
CalOMS Tx Data Collection Guide Jan 2014 (pdf)
2018-09-12

Billing
OTP Medicare PGE Tip Sheet (pdf)
Adding Benefit Plan Enrollment for OTP Medi-Medi clients 2021-03-03
Assignment of Insurance Benefits Form (pdf)
Revised 05-20-19 2019-07-22
BU Tip Sheet - Releasing Outpatient to OHC and Printing CMS 1500 Form (pdf)
Guides on how to process or release claims for clients with other health coverage and how to print the claim form via SanWITS. 2022-11-22
BU Tip Sheet - Releasing Residential Case Management to OHC and Printing CMS 1500 Form (pdf)
2020-08-05
Claim Item Hold Reasons (pdf)
to be utilized when putting claims in hold status 2020-10-02
DHCS 100186 Instructions (pdf)
How to complete the form 2020-09-25
DHCS 100186 or Claim Submission Certification Form (pdf)
Required billing certification form when submitting claim batch 2020-09-25
DHCS 6065A Form (pdf)
Late billing Good Cause Certification 2021-01-06
DHCS 6065A Form (xlsx)
Late billing Good Cause Certification 2021-01-06
DHCS 6065B Form (pdf)
Late billing and Good Cause Certification for DRC 8 2021-01-06
DHCS Drug Medi-Cal Billing Manual (pdf)
Updated April 2019 2019-04-29
DMC Organizational Providers Billing Manual (pdf)
Revised 04/20/2022 2022-04-25
Instructions on Completing 6065A Form
2021-01-06
Instructions on Completing 6065B Form
2021-01-06
MAT Dosing Same Day Billing Matrix (pdf)
2021-02-18
OTP Billing SanWITS Screens 11-21-2018 (pdf)
2018-12-06
OTP Disallowance After Release to Billing (pdf)
How to handle disallowances following the release to billing. Revised 12-15-2021 2021-12-16
OTP OOC Medi-Cal Tip Sheet (pdf)
2023-03-28
Outpatient Disallowance After Release to Billing (pdf)
This document is a revised version of the Disallowance After Release to Billing. It contains instructions on how to handle disallowances following the release to billing. 2021-12-16
Outpatient OOC Medi-Cal Tip Sheet (pdf)
2023-03-28
Outpatient Provider Billing SanWITS Screens (pdf)
Revised 06-14-2019 2019-06-21
PGE or Benefit Plan Review Billing Tip Sheet 11-19-2018 (pdf)
2018-12-06
Payment Recovery Form (Void-Disallowance) (xlsx)
Revised 09/2022 - Tab 2 contains the instructions. 2022-09-13
Residential Bed Day Billing SanWITS Screens (pdf)
Rev 05-01-2019 2019-06-10
Residential Bed Day Disallowance After Release to Billing (pdf)
How to handle disallowances following the release to billing. Revised 01/26/2022 2022-01-26
Residential Case Management Disallowance After Release to Billing (pdf)
How to handle disallowances following the release to billing. Revised 02-07-2022 2022-02-07
Residential Case Management-Recovery Services SanWITS Screens (pdf)
Rev 05-22-2019 2019-06-10
Residential OOC Medi-Cal Tip Sheet (pdf)
2023-03-28
SUD Aid Code Master Chart (xlsx)
2023-05-05
SUD Billing Announcement: Medicare Advantage Plan Rules for OTP Providers (msg)
Email announcement regarding Medicare Advantage billing rules 2022-07-14
SUD Billing Announcement: Other Health Coverage Rules for Outpatient Providers (msg)
Email announcement regarding OHC Rules 2022-07-14
SUD Billing Announcement: Other Health Coverage Rules for Residential Providers (msg)
Email announcement regarding OHC Rules 2022-07-14
SUD Billing Matrix (pdf)
2020-09-17
SUD DMC Billing Manual Summary of Changes (pdf)
Revised 10/20/2020 2020-10-26
SUD ICD-10 List (xls)
2019-11-25

PC1000
PC 1000 Education Track Fee (pdf)
2019-08-29
PC 1000 Participant Handout (docx)
` 2019-08-29
PC 1000 Participant Status Report (pdf)
` 2019-08-29
PC 1000 Program Manual (pdf)
` 2019-08-29
PC 1000 Program Orientation Checklist (docx)
` 2019-08-29
PC 1000 Referral Form (pdf)
` 2019-08-29
PC 1000 SanWITS Education Track Flow (pdf)
2019-08-29
PC 1000 SanWITS Treatment Flow (pdf)
2019-08-29

Medical Director Info
One-Pager – Medical Director in DMC-ODS (pdf)
2021-12-28
10.29.20 SUD MD Exec Summary.pdf
Uploaded 11/12/2020 2020-11-12
10.15.20 SUD MD Exec Summary.pdf
Uploaded 11/12/2020 2020-11-12
10.01.20 SUD MD Exec Summary.pdf
Uploaded 11/12/2020 2020-11-12
9.17.20 SUD MD Exec Summary.pdf
Uploaded 10/01/2020 2020-10-01
8.06.20 SUD MD Exec Summary.pdf
Uploaded 10/01/2020 2020-10-01
8.20.20 SUD MD Exec Summary.pdf
Uploaded 10/01/2020 2020-10-01
5.28.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.09.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
5.14.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.23.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.03.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
7.23.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
6.25.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
7.09.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.16.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
6.11.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
4.30.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
5.07.20_SUD_MD_Exec_Summary.pdf
Uploaded 08/13/2020 2020-08-13
One-Pager – Medical Director Training Requirements (pdf)
Revised 4/21/20 2020-04-30
QM Memo - Physical Exam Requirements (pdf)
2019-10-03

Recovery Residences

00 – Archived List - Recovery Residences (pdf)
Revised 10/29/2020 2020-10-30
2020-04-20 - COVID Invoice Reporting Guidelines (pdf)
2020-09-01
One-Pager Recovery Residences – Supplemental Funding (COVID) (pdf)
Effective during COVID Health Emergency 2020-10-30
Recovery Residence Census Revised (xlsx)
2020-09-01

Monitoring
00 – Archived List – Monitoring (pdf)
Updated 10/06/2022 2022-10-12
Annual CME-CEU Requirement Tip Sheet
Updated 02/17/2022 2022-03-08
Corrective Action Steps for Disallowed Services (pdf)
10/09/2020 2020-10-30
FAQ for Client Contacts and Timely Access (pdf)
2021-09-22
Interim Services (pdf)
Updated 03/13/2023 2023-03-14
Interim Services (pdf)
Updated 07/16/2021 2021-08-18
MRR Tool FY22-23 (pdf)
Revised 10/05/2022 2022-10-11
MRR Tool FY22-23 - OTP (pdf)
Updated 07/20/2022 2022-10-05
Medication Monitoring Instructions (pdf)
06/20/2019 2019-09-09
Medication Monitoring McFloop Form (pdf)
06/19/2019 2019-09-09
Medication Monitoring Submission Fillable Form (pdf)
Revised 10/28/2020 2022-04-05
Medication Monitoring Tool (pdf)
Updated 07/29/2021 2021-08-05
PSPP Tip Sheet (pdf)
10/10/2022 2022-10-12
Provider Self Reporting Tool for Disallowances (xlsx)
Revised 10/13/2021 2021-10-26
Reasons for Disallowance (FY22-23) (pdf)
2022-08-12
Self-Identified Disallowances - Tip Sheet (pdf)
Updated 10/1/2020 2020-11-09

Training - SanWITS

New SanWITS Training Tips and Resources page is now available for providers and Program Managers.

Video Tutorials

SanWITS Assessments Training
Intro to Admin Functions
Outpatient OTP Encounters
Recovery Residence Tracking
Residential Encounters Orientation and Practice

Training Manuals and Resources

Peer Support

00 – Archived List – Peer Support (pdf)
Updated 6/28/2022 2022-06-30
2023-05-17-BHS Memo-Update on Peer Support Services Implementation (pdf)
2023-05-25
BHS HPA Peer Support Specialist Services Q and A (pdf)
Updated 06/01/2023 2023-06-01
Certified Peers (pdf)
Updated 03/2022 2022-05-16
Info Notice – BHS Peer Support Specialist Certification Program (pdf)
10/05/2021 2021-10-18
San Diego Certified Peer Support Specialist – TRAINING REQUIRMENTS (docx)
2023-05-25
San Diego Certified Peer Support Specialists – Billing Codes (docx)
FY2022-2023 2023-05-31
Scholarship Flyer – Peer Support Specialist Certification Program (pdf)
2022-10-19

Contracts/Fiscal Admin Svcs
Info_Notice_-_FY_17-18_Start-up_Cost_Amendment_-_Attachment_2.xlsx
2018 01/12 Issued 2018-06-06
Info_Notice_-_Start-up_Enhancements_for_FY_17-18_and_FY_17-18_-_Attachment_1.xlsx
2018 01/31 Issued 2018-06-06
Info_Notice_-_FY_17-18_Start-up_Cost_Amendment_-_Attachment_1.xlsx
2018 01/12 Issued 2018-06-06
Info_Notice_-_FY_17-18_Start-up_Cost_Amendment.pdf
2018 01/12 Issued 2018-06-06
Info_Notice_-_Start-up_Enhancements_for_FY_17-18_and_FY_17-18.pdf
2018 01/31 Issued 2018-06-06
Info_Notice_-_FY_17-18_DMC-ODS_Enhancement_Budget-Invoice_Process.pdf
2018 04/05 Issued 2018-06-06
Info_Notice_-_FY_17-18_DMC-ODS_Enhancement_Budget-Invoice_Process_-_Attachment_2.xlsx
2018 04/05 Issued 2018-06-06
DMC Budget Master Template FINAL.xlsm
2021-09-02
FY2122 Provider Rate Cap (pdf)
2021-09-02
Info Notice - DMC-ODS Twice-a-Month Invoice Process (pdf)
2018 07/02 Issued 2018-07-09
Info Notice - DMC-ODS – Total Units of Service (TUOS) Report Distribution (pdf)
2019 08/13 Issued 2019-08-14
Info Notice - FY 17-18 DMC-ODS Enhancement Budget-Invoice Process - Attachment 1 (pdf)
2018 05/17 Issued 2018-06-06
Info Notice - Rate Cap Waiver Extension (Q3) (pdf)
2018 12/18 Emailed 2018-12-20
Info Notice - Rate Cap Waiver Extension (pdf)
2018 09/19 Emailed 2018-10-02
Info Notice - Rate Cap Waiver for First Quarter (Q1) (pdf)
2018 08/07 Issued 2018-08-09
Info Notice - Unit Production Plan (Q4) (pdf)
2019 04/04 Emailed 2019-04-10
Info Notice - Unit Production Plan (pdf)
June 17, 2019 2019-07-24
Info Notice – Extension of DMC Billable Unit Production Plan.pdf
Dec 19, 2019 2019-12-23
Info_Notice_-_FY_17-18_DMC-ODS_Enhancement_Budget-Invoice_Process_-_Attachment_3.xlsx
2018 04/05 Issued 2018-06-06
Invoicing – DMC-ODS Residential Providers (pdf)
June 27, 2019 2019-06-28
New TUOS Tip Sheet for Invoicing – OTP (pdf)
02/22/2022 2022-04-08
New TUOS Tip Sheet for Invoicing – RES and Outpatient (pdf)
02/22/2022 2022-04-08

MIS EHR Interop Project

CalAIM FAQ

CalAIM Behavioral Health Initiative FAQ's Available Online
SUD QA CalAIM FAQ (pdf)
October 21, 2022 2022-10-26