Medi-Cal Behavioral Health Plan - Provider Directory Website
MC BHP Handbook and Provider Directory Lobby Notice
Behavioral Health Plan Member Handbook
This guide will help you know what specialty mental health services are, if you may get them, and how you can get help from the Orange County BHP.
For general information and accessibility issues please call:
Orange County Behavioral Health Plan
Phone: 800-723-8641
For TTY/TDD users, call 711
- Behavioral Health Plan Member Handbook (English) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Arabic) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Chinese - Simplified) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Farsi) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Korean) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Russian) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Spanish) also in large print version *NEW 2025 edition*
- Behavioral Health Plan Member Handbook (Vietnamese) also in large print version *NEW 2025 edition*
This guide is available for listening in MP3 audio format in multiple languages.
About listening to files
| Handbook Audio Recording | English 2025
| Arabic 2025
| Chinese (Simplified) 2025
| Farsi 2025
| Korean 2025
| Russian 2025
| Spanish 2025
| Vietnamese 2025
|
BH Provider Handbook Coding Manual
Behavioral Health Provider Handbook Coding Manual Version 11 (November 2020)
(121 page pdf file)
Forms / Brochures
| Title | Arabic | Chinese | English | Farsi | Korean | Russian | Spanish | Vietnamese |
| Advance Health Care Directives (F346-705) |  | | | | | | ||
| Grievance or Appeal Form (F346-706) Grievance Tracking Form | | | | | | | | |
| Grievance & Appeal Process Posters *** UPDATED *** | | | | | | | | |
| Grievance Fact Sheet MHP | | | | | | | | |
| Authorization to Use and Disclose Protected Health Information (F346-531B) | | | | | | | | |
| Consent to Record (F346-474) | | | | | ||||
| Mental Health Plan Intake/Advisement Checklist (F346-753) | | | | | | | ||
| Psychiatric Medication Consent (F346-7921) | | | | | | | | |
BHS Combined Informed and Telehealth Consent
| | | | | | | | |
| AQIS Continuity of Care Request Form | | |||||||
| National Voter Registration Act (NVRA) Preference Forms (County Operated Provider Use Only) National Voter Registration FAQs | | | | | | |||
| Interpretation Services Poster | | |||||||
Supervision Reporting Forms | ||||||||
| Clinical Supervision Reporting Form *** UPDATED *** | | |||||||
| Clinical Supervisor Agreement (for County Programs only) *** NEW *** | | |||||||
| Medical Supervision Reporting Form *** UPDATED *** | | |||||||
Qualified Provider Supervision Form *** NEW 3/2025 ***
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NOABD | ||||||||
| Notice of Adverse Benefit Determination-Delivery System |  | | | | | | | |
| Notice of Adverse Benefit Determination- Modification Notice | | | | | | | | |
| Notice of Adverse Benefit Determination- Termination Notice | | | | | | | | |
| NOABD Member Non--Discrimination Notice | | | | | | | | |
| Notice of Adverse Benefit Determination- Your Rights Notice | | | | | | | | |
| Language tagline | | |||||||
Car Seat Safety Flyers (County Operated Provider Use Only)
Notice of Privacy Practices (NPP) (County Operated Provider Use Only)
Patients' Rights Downloads
For information and resources about the Drug Medi-Cal Organized Delivery System (DMC-ODS), visit http://www.ochealthinfo.com/DMC-ODS