Health Industry Collaboration Effort

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Looking for a final HICE document/template? They can be found in the Final HICE Documents folder - click here for a list of available documents for each HICE team: FINAL HICE DOCUMENTS.

FINAL HICE DOCUMENTS
Claims Standardization Team
Compliance Team
Compliance Team Delegated Entity (DE) Compliance Workgroup
Compliance Team IT Systems Integrity Workgroup
Credentialing Shared Audit Policy Team - Main / California
Credentialing Shared Audit Policy Team - Main / Mid-Atlantic
Credentialing Shared Audit Policy Team - Main / Mid-Atlantic / Northwest / Texas
Business Rules
Tools
		File	Upload	Review
	Title	Size	Date	Date
	2025_HICE_MA_NW_TX_Cred_Shared_Audit_Tool_112124.	589 KB	12/18/2024
	2025_HICE_MA_NW_TX_Accredited_Cred_Shared_Audit_Tool_112124	590 KB	12/18/2024
	MA_Cred Universe_Spreadsheet Template_2025	25 KB	1/7/2025
	TX_Cred Universe_Spreadsheet Template_2025	25 KB	1/7/2025
	NW_Cred Universe_Spreadsheet Template_2025	25 KB	1/7/2025
	HICE HealthPlan_Delegation_Audit_Release_Letter_2025	107 KB	1/7/2025
	HICE_MA_NW_TX_Annual_Desk_Top_Audit_Request_Letter_112124	111 KB	1/7/2025
	HICE_MA_NW_TX_Cred SA_Interrater_Procedures_2025	103 KB	1/7/2025
	HICE_NW_PrePosting_Letter_112124	115 KB	1/7/2025
	HICE_File_Checklist_Sample_2025_	65 KB	2/20/2025
	HICE Ongoing Monitoring Log 2025	13 KB	2/20/2025
	2025 HICE_MA_NW_TX_Credentialing_Shared_Audit_Training_Tool_Guidelines_022025_	862 KB	2/20/2025
	HICE_TX_PrePosting_Letter_022025	115 KB	2/20/2025
	HICE_MA_PrePosting_Letter_022025	115 KB	2/20/2025
Credentialing Shared Audit Policy Team - Main / Northwest
Credentialing Shared Audit Policy Team - Main / Texas
Cultural & Linguistic (C&L) Services Team
Cultural and Linguistics Provider Toolkit
Encounters Standardization Team
QI / UM Team - Main
Service Determination Standardization Team (SDS) - UM Templates & Tools
UM Required Reports Team (formerly QI and UM Required Reports Team)
UM Templates & Tools (1) - Health Plan-Specific Template Location
UM Templates & Tools (Commercial)
UM Templates & Tools (Medi-Cal)
UM Templates & Tools (Medicare Advantage)

HICE documents can be altered for use by organizations/other regions as needed; however, the HICE logo/any HICE references should be removed if the document is not being used in its original format. Documents available within the Library are intended to be used as printed documents. To the extent such documents are used digitally, it shall be the user's responsibility to ensure their use of the documents adheres to the accessibility standards applicable to their organization.

HICE is a voluntary 501(c)3 organization that includes participation by and advice from accrediting and regulatory agencies. The goal of HICE work products is to offer HICE participating organizations standardized tools and best practices toward optimizing efficiencies to implement health industry requirements. HICE heeds feedback from accrediting and regulatory agency partners regarding HICE work products; however, HICE does not obtain official regulatory approval for its work products. As such, HICE work products are not to be considered exempt from any approval process required by regulatory agencies.