Individual & Group Manual

Click the link below to download the entire Individual and Group Provider Manual.

Individual and Group Provider Manual(PDF, 7MB)

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

Welcome Page(PDF, 393KB)
Table of Contents(PDF, 100KB)
Introduction(PDF, 90KB)
Section 1 - Access and Referral(PDF, 424KB)
Section 2 - Services Requiring Authorization(PDF, 295KB)
Section 3 - Medical Necessity Criteria(PDF, 242KB)
Section 4 - Eligibility and Claims(PDF, 2MB)
Section 5 - Quality Management(PDF, 2MB)
Section 6 - Problem Resolution and Appeal Process(PDF, 224KB)
Section 7 - Cultural and Linguistic Standards(PDF, 185KB)
Section 8 - Site Certification / Medical Record Review(PDF, 1MB)
Section 9 - Medical Records(PDF, 1MB)
Section 10 - Documentation Standards(PDF, 427KB)
Section 11 - Coordination of Physical and Mental Health Care(PDF, 125KB)
Section 12 - County Resources(PDF, 85KB)
Section 13 - Forms and Definitions of Terms(PDF, 95KB)

Contact Us

Fresno County Mental Health Plan
P. O. Box 45003
Fresno, CA. 93718-9886

Contact Info

Phone: (559) 600-4645
Fax: (559) 455-4633
TTY: 711

For billing questions and inquiries, contact Managed Care at (559) 600-4645 and ask to speak to a Provider Relations Specialists.

For authorization questions, contact Managed Care (559) 600-4645 and asks to speak to a Utilization Review Specialists.

If you have a Behavioral Health emergency
please call 9-1-1

Central Valley Suicide Prevention Lifeline
988

Mobile Crisis Response
(559) 600-6000

For Access to Services or the Crisis Line,
1 800 654-3937

CalHOPE Warm Line
1 833 317-HOPE(4673)