Provider Manual

The FCMHP Provider Manual has been updated. There is now one version of the manual for all provider types (Individual/Group and Organizational). Differences in procedure for different provider types are noted in the manual.

Welcome! Thank you for choosing to become a provider for the Fresno County Mental Health Plan (FCMHP). The FCMHP is committed to providing community-oriented, culturally-sensitive, and high-quality mental health services to Fresno County Medi-Cal beneficiaries. Your participation gives Fresno County's Medi-Cal mental health consumers improved and expanded access to mental health care.

The Provider Manual contains important information about the FCMHP. It outlines how Medi-Cal beneficiaries seeking mental health treatment can access services and explains how a provider can submit claims for services. This manual also describes the Problem Resolution Process, the Quality Improvement standards adopted by the FCMHP, HIPAA observance, Fresno County's cultural and linguistic standards, and other resources and information valuable to a new provider.

Thank you for choosing to become one of our providers. If you have any questions or need assistance, please feel free to contact Managed Care at (559) 600-4645 during business hours, and a Utilization Review Specialist or a Provider Relations Specialist will be happy to assist you. We look forward to working with you.

Click the link below to download the entire FCMHP Provider Manual:

• FCMHP Provider Manual(PDF, 6MB)
• ATD Clinical Guide For Contracted Providers(PDF, 191KB)

If you are interested in viewing, printing, or downloading specific sections of the FCMHP Provider Manual, please click on the desired section below.

• Welcome Page(PDF, 231KB)
• Table of Contents(PDF, 98KB)
• Introduction(PDF, 113KB)
• Section 1 - Access and Referral(PDF, 400KB)
• Section 2 - Services Requiring Authorization(PDF, 184KB)
• Section 3 - Medical Necessity Criteria(PDF, 209KB)
• Section 4 - Service Definition(PDF, 223KB)
• Section 5 - Therapeutic Behavioral Services(PDF, 1MB)
• Section 6 - Eligibility and Claims(PDF, 2MB)
• Section 7 - Quality Management(PDF, 680KB)
• Section 8 - Problem Resolution Process and Appeal(PDF, 94KB)
• Section 9 - Cultural and Linguistic Standards(PDF, 181KB)
• Section 10 - Site Certification-Medical Record Review(PDF, 1MB)
• Section 11 - Medical Records(PDF, 747KB)
• Section 12 - Documentation Standards(PDF, 451KB)
• Section 13 - Coordination of Physical and Mental Health Care(PDF, 103KB)
• Section 14 - Court Referred Cases(PDF, 232KB)
• Section 15 - Forms and Definitions of Terms(PDF, 87KB)
• Section 16 - Insurance and Other Requirements(PDF, 947KB)
• Section 17 - County Resources(PDF, 74KB)