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


APPROVED HICE DOCUMENTS

 Click to open category Appeals and Grievances Improvement Team  
 Click to close category Claims  
     Click to open category Approved 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.
     Click to open category CMS Provider Dispute Resolution (PDR) Process Documents
     Click to close category Click to Download All Documents in Subfolder Commercial Provider Dispute Resolution (PDR) Process Documents
       File   Upload   Review
  Title     Size   Date   Date
  2008 PDR LTR CHANGES   30 KB   10/17/2007   12/8/2020
  Coml_ClaimsPDR_Report_Addresses_022807   24 KB   5/1/2007   12/8/2020
  FAIL TO SUBMIT INFO CLOSURE LTR 0108   29 KB   10/17/2007   12/8/2020
  ICE _Claims_Medi-Cal PDR_QTRProvDisputesRpt   73 KB   6/6/2017   1/8/2021
  ICE Claims ComlQtrProvDisputesRpt 10-31final   52 KB   9/7/2006   12/8/2020
  ICE PDR 101 Guide 10-2009   6857 KB   11/10/2009   2/18/2020
  MULTI DISP ACK LTR 0108   30 KB   10/17/2007   12/8/2020
  NON UM UPHLD DISC LTR 0108   30 KB   10/17/2007   12/8/2020
  OVERTN CLOSURE LTR PAYMT 0108   28 KB   10/17/2007   12/8/2020
  PDR Form combined 0108   108 KB   10/17/2007   12/8/2020
  SINGLE DISP ACK ADD INFO NEEDED 0108   30 KB   10/17/2007   12/8/2020
  SINGLE DISP ACK LTR NO INFO 0108   28 KB   10/17/2007   12/8/2020
  UPHELD DISP RES LTR 0108   28 KB   10/17/2007   12/8/2020
  UPHELD UM CLOS LTR 0108   30 KB   10/17/2007   12/8/2020
     Click to open category Training Documents
 Click to open category Compliance Team (formerly Contracting & Compliance Team)  
 Click to open category Compliance Team Delegated Entity (DE) Compliance Workgroup  
 Click to open category Compliance Team IT Systems Integrity Workgroup  
 Click to open category Credentialing Shared Audit Policy Team - Main / California  
 Click to open category Credentialing Shared Audit Policy Team - Main / Mid-Atlantic  
 Click to open category Credentialing Shared Audit Policy Team - Main / Northwest  
 Click to open category Credentialing Shared Audit Policy Team - Main / Texas  
 Click to open category Cultural & Linguistic Services Team  
 Click to open category Cultural and Linguistics Provider Toolkit  
 Click to open category Encounters Standardization Team  
 Click to open category QI / UM Team - Main  
 Click to open category UM Required Reports Team (formerly QI and UM Required Reports Team)  
 Click to open category UM Templates & Tools (1) - Health Plan-Specific Template Location  
 Click to open category UM Templates & Tools (Commercial)  
 Click to open category UM Templates & Tools (Medi-Cal)  
 Click to open category 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.

   


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