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Looking for an approved ICE document/template? They can be found in the Approved ICE Documents folder - click here for a list of available documents for each ICE team: APPROVED ICE DOCUMENTS.

APPROVED ICE DOCUMENTS

Appeals and Grievances Improvement Team

Arizona Office Review Improvement Team (Facility Site Reviews)

California SB260

Claims

CMS Forms (frequently used)

Contracting & Compliance Team

Credentialing Shared Audit Policy Team - Main

Cultural & Linguistic Services Team

Cultural and Linguistics Provider Toolkit

DMHC LAP Plan-Provider Contract Amendment Boilerplates

HIPAA

Medi-Cal Notice of Action (NOA) Translated Templates

Office Review Improvement Team (Facility Site Reviews)

Sharing Office Reviews

Part D Exceptions/Appeals Team (PEAT)

Part D Implementation Team

Provider Dispute Resolution

Provider Group Oversight - Appeals

QI/UM - MA Part C Reporting Requirements

QI/UM Required Reports (former Coalition)

Risk Adjustment Data Acquisition & Reporting (RADAR)

Site Visit Team

Standardized Provider Group Referral Form and Direct Specialist Referral Form

UM Shared Audit Team

UM TATs (Standard UM Turn Around Times)

UM Templates & Tools (Commercial & Medicare Advantage)

UM Templates & Tools (Commercial UM LAP Templates for LAP Regulations Effective on and after 1/1/09)

UM Templates & Tools (Medi-Cal)

UM Templates & Tools (Medicare Advantage Templates for Marketing Guidelines effective 1/1/10)

	Adobe Acrobat File
	Microsoft Word File
	Microsoft Excel File
	Microsoft PowerPoint File
	Zipped File
	Unknown File Type

Many Library documents are in Adobe Acrobat format. If you do not have Acrobat you may download it here.

To download a document, right-click the document title and select "Save Target As..." (or the equivalent). You may left-click a document to open it in your browser. Note: Opening a Microsoft Office document in your browser may trigger a known issue that causes a password prompt to appear for non-password protected documents. Information from Microsoft about how to resolve this issue on your computer is available here, here, and here.