Health Industry Collaboration Effort

Library   

View our Library Tutorial videos for information on how to browse and search the Library.

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
Advanced Diagnostic Imaging (ADI) Documents
CMS Provider Dispute Resolution (PDR) Process Documents
Commercial Provider Dispute Resolution (PDR) Process Documents
Final Claims Documents
Health plan-specific letter templates that used to be located in this area of the library can now be found in the Health Plan Specific Letter Templates library document section here.
		File	Upload	Review
	Title	Size	Date	Date
	ClaimsPDR_Report_Addresses_09.09.2022	112 KB	9/23/2022
	HICE_Claims_Medicare_Advantage_Denial_Reason_Guide_Reviewed 06.02.2023	306 KB	6/7/2023
	HICE_Claims_Commercial_Denial_Reasons_Guide_Reviewed_06.02.2023	268 KB	6/7/2023
	HICE_Claims_Medi-Cal_MoQtr_Final___rev_2_24	78 KB	3/4/2024
	HICE_Claims_Standardization_Team_Assembly_Bill_72_09252020_Updated2024	218 KB	3/19/2024
	HICE_Claims_Comm_MoQtr_Final_rev_02_2024	80 KB	4/25/2024
	HICE_Multi_Principal_Officer_Form_PDR_primary and alternate_Final_3.20.25	122 KB	4/3/2025
	HICE_Multi_Principal_Officer_Form_dual claims and pdr same signatory_Final_3.20.25	122 KB	4/3/2025
	HICE_Multi_Principal_Officer_Form_claims primary and alternate_Final_3.20.25	122 KB	4/3/2025
	HICE_Claims_Operational_Questionnaire-2025.v2	107 KB	4/7/2025
	HICE_CMS_MA_MTR_revised_02_2025	73 KB	4/7/2025
Training Documents
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
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.