QA Forms and Documentation



Informing Materials Initial Forms that Must be in the Chart & Signed by the Consumer Documents You Must Offer Your Consumers Documents that Must be Available in Your Lobby/Office HIPAA BHCS HIPAA Notice Notice of Privacy Practices Policy Update (Memo 2009) Notice of Privacy Practices (Information & Form) - English, Spanish, Chinese, Farsi & Vietnamese Authorization to Disclose Individually Identifiable Health Information (IIHI) (Sample Form) For more information, visit the HIPAA section on BHCS Website. Beneficiary Beneficiary Rights Policy Consumer Grievance and Appeal Process Beneficiary Problem Resolution Information (Form) - English, Spanish, Chinese, Farsi & Vietnamese Beneficiary Death Report Form Advance Directive Your Right to Make Decisions About Medical Treatment Policy (revised 2004) Advance Directive (Form) Guide to Medi-Cal MH Services Policy Memo Guide - English, Spanish, Chinese, Farsi, Vietnamese, Lao, Cambodian & Korean Peer Review Policy & Procedure FAQ Report Format Documentation Standards Level 3 Audit Tool (44kb, Excel) Standard Abbreviations Certification & Credentialing Organization Provider Certifications Policy Checklist Day Treatment Intensive Day Treatment Rehabilitative Individual and Group Provider Credentialing Policy