Dhcs Medical Review Branch

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Audits & Investigation - Medical Review Branch (MRB)

https://www.dhcs.ca.gov/individuals/Pages/AI-CERD.aspx

Audits & Investigation - Medical Review Branch (MRB) Medical Review Branch. The Medical Review Branch (MRB) focuses on maintaining program integrity within the Medi-Cal program through reviews, audits, inspections and surveys of …

Medical Review Audits and Corrective Action Plans

https://www.dhcs.ca.gov/services/Pages/MedRevAuditsCAP.aspx

DHCS makes a finding of fact with respect to the ability of the MCPs to provide quality health care services, the effectiveness of peer review, and utilization control …

Medical Review Branch - Payment Error Rate …

https://www.dhcs.ca.gov/individuals/Pages/AI_MRB_PERM.aspx

PERM is comprised of three review components: Fee-for-Service (FFS) paid claims, Managed Care (MC) capitation payments, and Eligibility. For the FFS review …

Audits & Investigations - California

https://www.dhcs.ca.gov/individuals/Pages/AuditsInvestigations.aspx

Missio n. Audits and Investigations Division (A&I) is the designated Program Integrity Unit (PIU) for the Medi-Cal program. A&I’s mission is protect and enhance the …

DHCS Homepage

https://www.dhcs.ca.gov/

The budget for DHCS supports vital services that reinforce the state’s commitment to preserve and improve the overall health and well-being of all Californians while …

A&I - Investigations Branch - California

https://www.dhcs.ca.gov/individuals/Pages/AI_IB_Provider.aspx

DHCS/IB investigates “preliminary” provider fraud complaints. After a preliminary investigation is completed and reasonable cause has been established to …

Forms

https://www.dhcs.ca.gov/formsandpubs/forms

About DHCS Translate Home Services Individuals Providers & Partners Laws & Regulations Data & Statistics Forms & Publications Search Forms Access forms …

DHCS Medical Record Review (MRR) Checklist - Central …

https://thealliance.health/for-providers/manage-care/quality-of-care/site-reviews/dhcs-medical-record-review-mrr-check-list/

DHCS Medical Record Review (MRR) Checklist - Central California Alliance for Health Home > For Providers > Manage Care > Quality of Care > Site Reviews > DHCS Medical …

Audits & Investigations Forms - California

https://www.dhcs.ca.gov/formsandpubs/forms/Pages/AuditsInvestigationsForms.aspx

DHCS facility Cost Report forms are available for download below. The Financial Review Division (FRD) audits filed Cost Report forms and updates the Cost Report form list. …

Medi-Cal: Post-Service, Prepayment Audit (PPM Audit) …

https://files.medi-cal.ca.gov/pubsdoco/special_claims_faq.aspx

A PPM Audit (formerly known as Special Claims Review [SCR]) is a utilization control process that the Department of Health Care Services (DHCS) uses to …

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