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
Appeals and Grievances Improvement Team
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
Business Rules
Site Visit Tools
Tools
		File	Upload	Review
	Title	Size	Date	Date
	PO_Practitioner_Spreadsheet_Template_2015	27 KB	4/22/2015	4/23/2024
	PO_Release_Letter_020122	33 KB	2/1/2022
	HICE Cred Quarterly Report Template_03.08.23	61 KB	3/8/2023
	HICE Cred Semi-Annual Report Template_03.08.23	61 KB	3/8/2023
	HICE_Cred_Report_Template_INSTRUCTIONS_05.16.23	59 KB	5/17/2023
	HICE Organizational_Provider__Summary__Review_Checklist_1.18.2024	31 KB	1/19/2024
	HICE_CA_Interrater_Procedures_01.18.2024	35 KB	1/19/2024
	HICE_Desk_Audit_Process_POs_01.18.2024	47 KB	1/19/2024
	HICE_File_Checklist_Sample__2024_CA	65 KB	1/19/2024
	HICE_Office_Site_Complaint_Tool_01.18.24	84 KB	1/19/2024
	HICE_Organizational_Provider_Worksheet_01.18.2024	37 KB	1/19/2024
	HealthPlan_Delegation_Audit_Release_letter_020122	33 KB	7/1/2024
	2025_HICE_Accredited-Certified_CA_Shared_Audit_Tool_01.22.2025	433 KB	1/24/2025
	2025_CA_HICE_Shared_Audit_Training_Tool_1.22.2025	891 KB	1/24/2025
	2025_HICE_CA_Shared_Audit_Tool_2.19.2025	423 KB	2/20/2025
	2025_HICE_Accredited-Certified_CA_Shared_Audit_Tool_02.19.2025	435 KB	2/20/2025
	HICE_PrePosting_Letter_03-03-25	309 KB	3/3/2025
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.