CenCal Health

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Seleccione Su Plan Health Initiative Healthy Families Prenatal Plus2 In-Home Support Healthy Kids SB Healthy Kids SLO HIPAA Privacy Practices & Confidentiality

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	For Providers > Audit Process for Medi-Cal Providers
	For Providers -Audit Process for Medi-Cal Providers



	CenCal Health conducts facility audits for new providers (only PCPs and OB/Gyns that provide routine obstetrical care) as a requirement for participation in all CenCal Health programs. A full scope Santa Barbara Health Initiative (SBHI) review will be conducted utilizing the California Department of Health Services Medi-Cal Managed Care Full Scope Site Review Survey and Medical Record Survey Tool. Reviews for all programs other than Medi-Cal will be performed using the Industry Collaboration Effort (ICE) California Shared Commercial & Medicare Site Review Survey. Supplemental criteria may be assessed by CenCal Health to address additional requirements. After the initial full scope survey, the maximum time period before the next required full scope site survey is three years. CenCal Health may review sites more frequently, or when determined necessary based on prior findings. Follow the links below for the content of the audit tools utilized for the audits. Providers may download or print these documents for reference in preparing for site visits. Facility Site Audit Review Criteria Medical Record Review Criteria Audit Resources Adult Preventive Health Form Pediatric Preventive Health Form Advanced Health Care Directives (English and Spanish) SBHI Complaint Form (English) SBHI Complaint Form (Spanish) How to Prepare for a CenCal Health Facility Site Audit How to Prepare for a CenCal Health Medical Record Audit Medication Record Monthly Emergency Checklist Monthly Quality Assurance Checklist Refrigerator Log Emergency Management Procedure TB Screening Questionnaire (English and Spanish) Staff Inservice Education Sign-in Sheet