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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 SB168 Alternate Patient Identifier
California SB260
Claims
CMS Forms (frequently used)
Contracting & Compliance Team
Credentialing Shared Audit Policy Team - Main
Cultural & Linguistic Services Team
DMHC Language Assistance Program
		File	Upload
	Title	Size	Date
	C&L Education & Training_Workgroup_FAQ_for_Providers_Approved 9.19.08	78 KB	9/19/2008
	CA_Language_Assistance_Program-_training_outline_3-11-08(1)_Approved_4.08	33 KB	4/17/2008
	Healthplan_CA_LAP_Contact_Sheet_3_09_Approved	34 KB	7/31/2009
	ICE DMHC LAP Pre-Delegation Assessment Tool_FINAL_20080404	148 KB	4/8/2008
	ICE Education Matrix_6-20-08	91 KB	6/24/2008
	ICE Interpreter Quality Standards_v1_8.26.08.doc	42 KB	8/26/2008
	ICE Language Capability Verification Form	46 KB	9/30/2008
	ICE LAP Non-Delegation Assessment Tool_FINAL_Approved_9.19.08	98 KB	11/18/2008
	ICE Threshold_Languages_grid.v6	49 KB	6/17/2008
	ICE_DMHC_LAP_Notice_for_Non-Standard_Vital_Documents_APPROVED_032408	40 KB	3/25/2008
	ICE_DMHC_Notice_of_Translation_for_English_Vital_Documents_FOR_PLANS_ONLY	233 KB	9/4/2008
	DMHC LAP translation services notice to accompany a vital document sent in English to a member not identified as LEP. ONLY FOR PLAN USE.
	ICE_LAP-Not_Delegated_Policy__Procedure FINAL_Approved_9.19.08	69 KB	9/19/2008
	ICE_SB853_Provider_Power_Point_Final	186 KB	12/17/2008
	ICE_Self-assessment-update_approved_main_team_final(2)	71 KB	9/2/2009
	Language_Assistance_Program_Timeliness_Standards_6.20.08	44 KB	6/24/2008
	LAP_Delegation_Checklist_Tool__0909099(FINAL)	131 KB	11/3/2009
	Provider_Organization_LAP_Contact_Worksheet_05_09	37 KB	5/27/2009
	Tips for Working with Interpreters_6.27.08	57 KB	6/27/2008
	Tips for Working with Limited English Proficient Members_6.27.08	44 KB	6/27/2008
	Tips_for_Documenting_Refusal_of_Interpretive_Final_6.20.08	48 KB	6/24/2008
	Translation_Checklist(1)_Approved_04.08	37 KB	4/17/2008
DMHC LAP Plan-Provider Contract Amendment Boilerplates
Cultural and Linguistics Provider Toolkit
DMHC LAP Plan-Provider Contract Amendment Boilerplates
Expedited Review
HIPAA
Medi-Cal Notice of Action (NOA) Translated Templates
Office Review Improvement Team (Facility Site 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 Sample P&Ps
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)

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

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