MC MHP Handbook and Provider Directory Lobby Notice
Consumer Handbook - Guide to Medi-Cal Mental Health Services
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This guide will help you know what specialty mental health services are, if you may get them, and how you can get help from the Orange County MHP.
For general information and accessibility issues please call:
Orange County Mental Health Plan
Phone: 800-723-8641
For TTY/TDD users, call 711

This guide is also available (MP3 audio format) in multiple languages.
About listening to files
BH Provider Handbook Coding Manual
Forms / Brochures
Advance Health Care Directives (F346-705) |

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Grievance or Appeal Form (F346-706) Grievance Tracking Form |

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Grievance & Appeal Process Posters *** UPDATED *** |

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Grievance Fact Sheet MHP |
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Authorization to Use and Disclose Protected Health Information (F346-531B) |

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Consent to Record (F346-474) |
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Mental Health Plan Intake/Advisement Checklist (F346-753) |

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Psychiatric Medication Consent (F346-7921) |

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Informed Consent for Services - General (F346-301) |

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Informed Consent for Telehealth and Telephonic Services |

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Telehealth Email Acknowledgement Form |

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AQIS Continuity of Care Request Form |
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National Voter Registration Act (NVRA) Preference Forms (County Operated Provider Use Only) National Voter Registration FAQs
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Clinical Supervision Reporting Form
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NOABD
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Notice of Adverse Benefit Determination-Delivery System |

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Notice of Adverse Benefit Determination- Modification Notice |

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Notice of Adverse Benefit Determination- Termination Notice |

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NOABD Beneficiary Non--Discrimination Notice |

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Notice of Adverse Benefit Determination- Your Rights Notice |

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Language tagline |
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NOABD-Delivery System, Modifications and Termination, Reminders 12/2018 |
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Car Seat Safety Flyers (County Operated Provider Use Only)
Notice of Privacy Practices (NPP) (County Operated Provider Use Only)
Patients' Rights Downloads
For information and resources about the Drug Medi-Cal Organized Delivery System (DMC-ODS), visit http://www.ochealthinfo.com/DMC-ODS