Procurement Office
RFP ADHS13-00002257, Exhibit 7, Documents Incorporated by Reference
The following list contains the Documents Incorporated by Reference (DIBR) referenced in the Scope of Work, Section 18.2. All documents listed by numbers are considered parent documents. Names listed under a parent document are related to the parent document and are contained within the parent document file.
- 7.1 ADHS Accounting and Auditing Procedures Manual
- 7.2 ADHS/DBHS Center for Mental Health Services (CMHS) Frequently Asked Questions
- 7.3 ADHS/DBHS Policy and Procedure Manual
- 7.4 ADHS/DBHS Provider Manual Template
- 7.5 ADHS/DBHS Housing Desktop Manual
- Application for Housing Development Under the Arizona Department of Health Services
- ADHS/DBHS T/RBHA Housing Project Proposal Outline Form
- Quarterly Supervisory Care Home/Board and Care Home Report
- 7.6 ADHS/DBHS Bureau of Quality Management Operations Specifications Manual
- Pharmacy Template
- QOC Monthly Reporting Template
- Compliant Log Description Code List
- Part I Guide for Behavioral Health Services Tool
- Part II Guide for Behavioral Health Services Tool
- Performance Improvement Plan Template
- Enrollee Grievance Report Template
- 7.7 ADHS/DBHS Children's System of Care Strategic Plan
- 7.8 ADHS/DBHS Covered Behavioral Health Services Guide
- 7.9 ADHS/DBHS Financial Reporting Guide for GSA 6
- 7.10 ADHS/DBHS Member Handbook Template
- 7.11 ADHS/DBHS Medication List
- 7.12 ADHS/DBHS Operations and Procedures Manual
- 7.13 ADHS/DBHS Prevention Framework for Prevention in Behavioral Health
- 7.14 ADHS/DBHS Agreements
- LARC Local Alcoholism Reception
- LARC Local Alcoholism Reception Amendment 2
- Agreement ADHS/DBHS Valley of the Sun United Way for Supportive Housing Pilot
- 7.15 AHCCCS 834 5010 Companion Guide
- 7.16 AHCCCS Approved EPSDT Tracking Form
- 7.17 AHCCCS Claims Dashboard Reporting Guide
- 7.18 AHCCCS Contractor Operations Manual
- 7.19 AHCCCS Encounter Manual

- 7.20 AHCCCS Encounter Data Validation Technical Assitance Document
- 7.21 AHCCCS Grievance System Reporting Guide
- 7.22 AHCCCS HIPAA Transaction Companion Guides and Trading Partner Agreements
- 270 - 271 Batch Eligibility Request and Response Guide
- 277 - Unsolicited Encounter Status Companion Guide
- 276 - 277 Batch Eligibility Request and Response Companion Guide
- 837 Counter Companion Guide
- 834-820 Enrollment and Capitation Companion Guide
- NCDP Post Adjudicated History Transaction Guide
- 7.23 AHCCCS Medical and Policy Manual

- 7.24 AHCCCS Minimum Required Prescription Drug List

- 7.25 AHCCCS Program Integrity Reporting Guide
- 7.26 AHCCCS Provider Affiliation Transmission Manual
- 7.27 AHCCCS Reporting Guide for Acute Care Contractors
- 7.28 AHCCCS Technical Interface Guidelines
- 7.29 Arnold v. Sarn Final Agreement, May 2012
- 7.30 ADHS/DBHS Client Information System (CIS) File Layouts and Specifications Manual
- 7.31 Clinical Guidance Documents
- Support and Rehabilitation Services for Children, Adolescents and Young Adults
- Youth Involvement in Arizona Behavioral Health System
- The Unique Behavioral Health Service Needs of Children, Youth and Families Involved with CPS
- Children's Out-of-Home Services
- The Child Family Team
- Family and Youth Involvement in the Children's Behavioral Health System
- 7.32 ADHS/DBHS Cultural Competency Guidance Documents
- Cultural Competency Narrative Report
- Cultural Competency Work Plan Initiatives (2011-12)
- Cultural Competency Work Plan Requirements Guide
- CC Plan Effect Review Report FY 2010 2011
- 7.33 ADHS/DBHS Demographic and Outcomes Data Set User Guide (DUG)
- 7.34 ADHS/DBHS Interagency Service / Intergovernmental Agreements
- Interagency Service Agreement between ADHS and AHCCCS
- Interagency Service Agreement between ADHS and DES
- ISA ADHS/DBHS ADOH for Housing Technical Assistance
- ISA ADHS/DBHS ADOH for State Housing Trust Fund, Amendment 4
- ISA ADHS/DBHS ADOH for State Housing Trust Fund, Original
- ISA ADHS/DBHS ADOH for Administration of Housing Funds
- Maricopa County, Services Remanded Juveniles
- Maricopa County, SMI Substance Abuse
- ISA Between ADHS and ADES-RSA
- 7.35 IT Guidance Documents
- 834 Sample upd
- 834 Phase II Samples
- 834 5010 AHCCCS Mapping
- 7.36 JK v Humble Court Orders
- JK Settlement
- JK Stipulation to Amend Settlement Agreement
- JK Notice of Proposed Settlement
- 7.37 Network Guidance Documents
- Network Provider Listing Recording Template
- Network Adult Child Provider Listing Instructions
- Adult Child Network Analysis Instructions
- 7.38 ADHS/DBHS Office of Grievance and Appeals Docket Tracking Application User's Guide
- 7.39 Quality Management Guidance Documents
- ADHS/DBHS Quality Management Plan
- ADHS/DBHS Quality Management Plan, FY 2012
- ADHS/DBHS Medical Management Plan, FY 2012
- ADHS/DBHS Medical Management-Utilization Management Work Plan, FY2012
- ADHS/DBHS Work Plan, FY 2012
- 7.40 Maricopa County Superior Court Administrative Order, Procedures to Share Identifying Information for individuals with SMI
Note: Information provided in PDF files, unless otherwise noted.