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Direct Provider Contracts

Direct Provider Incorporated Document Links

​Document 1F(b): Reporting Requirement Matrix - Direct Contract Submission
​Document 1G: Perinatal Services Network Guidelines 2018-19
​Document 1K:

Drug and Alcohol Treatment Access Report

Drug and Alcohol Treatment Access Report (DATAR) User Manual

​Document 1P: Alcohol and/or Other Drug Program Certification Standards
​Document 1V: Youth Treatment Guidelines
​Document 2A: Sobky v. Smoley, Judgment, Signed February 1, 1995
​Document 2C: ​Title 22, California Code of Regulations, Title 22, Sections 51341.1, 51490.1, and 51516.1
​Document 2F(a): Minimum Quality Drug Treatment Standards
​Document 2G: Drug Medi-Cal Billing M​anual
​Document 2K:

​Multiple Billing Override Certification - Form  MC 6700

Form | Instructions

​Document 2Q:

DHCS Form MC 6002 - Direct Provider Certification - Year-End Claim to Reimbursement (Mailed to providers separately by the Fiscal Management and Accountability Section)

​Document 2Q(a):

Drug Medi-Cal Provider Cost Report Excel Workbook (Mailed to providers separately by the Fiscal Management and Accountability Section)

​Document 2Q(e):

​Drug Medi-Cal Cost Report Forms - Residential - Perinatal - Forms MC 6005 and MC 6006

Forms | Instructions

​Document 3G:

​California Code of Regulations,  Title 9. Rehabilitative and Developmental Services -Division 4. Department of Alcohol and Drug Programs

Chapter 4. Narcotic Treatment Programs

​Document 3H:

​California Code of Regulations, Title 9. Rehabilitative and Developmental Services -Division 4. Department of Alcohol and Drug Programs

Chapter 8. Certification of Alcohol and Other Drug counselors

​Document 3J: CalOMS Treatment Data Collection Guide
​Document 3S: CalOMS Treatment Data Compliance Standards
​Document 3V: Culturally and Linguistically Appropriate Services (CLAS) National Standards
​Document 4C:

​Drug Medi-Cal Claim Submission Certification - Direct Contract Provider Form 100185

Form | Instructions

​Document 5A: Confidentiality Agreement
  

 

 

Last modified date: 2/13/2023 12:21 PM