ACBH Grievance and Appeals System



Alameda County Behavioral Health (ACBH) is committed to providing high quality Specialty Mental Health and Substance Use Disorder Services and have designed a Grievance System that enables beneficiaries to seek resolution to a problem or concern related to the Behavioral Health Care Plan. We strive to offer a Grievance and Appeal Process that is easy to access, timely, and responsive to the concerns and experiences of beneficiaries. DHCS Notice: Federal Grievance and Appeal System Requirements with Revised Beneficiary Notice Templates Grievance and Appeal Policy: Consumer Grievance and Appeal Processes for Medi-Cal Specialty Mental Health Services and Mental Health Services Act Program Policy Grievance Manual: ACBH Grievance and Appeal Manual ALAMEDA COUNTY BEHAVIORAL HEALTH GRIEVANCE SYSTEM RESOURCES Grievance Templates for Providers: Letter of Acknowledgement - This template has been translated per DHCS mandate - English Chinese Simplified Spanish Farsi Chinese Traditional Tagalog Korean Vietnamese Provider Notice of Grievance Appeal Letter of Extension NOABD Grievance and Appeal Timely Resolution - this letter must be accompanied by 3 Beneficiary Enclosures: Language Assistance; Beneficiary Non-Discrimination; & Your Rights Provider Disposition Letter Notice of Grievance Resolution - this letter must be accompanied by 2 Beneficiary Enclosures: Language Assistance & Beneficiary Non-Discrimination Notice Grievance Forms for Providers: File Document Checklist Grievance Call Form Investigation Notes Please obtain Consumer Grievance and Appeal forms and information from the Informing Materials Page. NOTICE OF ADVERSE BENEFICIARY DECISION Description: Notice of Adverse Beneficiary Decision is a subset of the Grievance System. It provides Medicaid (Medi-Cal) beneficiaries timely and understandable written notification when an adverse benefit determination for specialty mental health (SMHS) or substance use disorder (SUD) services is made; notification inclusive of beneficiary rights, such as the right to appeal. ALAMEDA COUNTY BEHAVIORAL HEALTH NOTICE OF ADVERSE BENEFIT DETERMINATION RESOURCES Policy: Notices of Adverse Benefit Determination for Medi-Cal Beneficiaries \| NOABD Table: A quick reference guide NOABD Templates in: English \| Chinese (Traditional) \| Chinese Simplified \| Spanish \| Tagalog \| Vietnamese \| Korean \| Farsi \| Arabic NOABD Beneficiary Enclosures: English \| Chinese (Simplified) \| Chinese (Traditional) \| Spanish \| Tagalog \| Vietnamese \| Korean \| Farsi \| Arabic TRAINING POWER POINTS FOR NOABD DETERMINATION FOR MEDI-CAL BENEFICIARIES Substance Use Disorder Treatment: SUD Treatment Children's Treatment: Children's TX Adult System of Care: TX COVID-19 COVID-19 State Fair Hearing Requests For further assistance, please see: Informing Materials: To ensure the appropriate informing materials are available to Medi-Cal beneficiaries, as required by the California Department of Health Care Services. Frequently Asked Questions QA Technical Assistance Contacts: To answer questions related to clinical documentation standards and procedure code billing questions.