Forms / Resources

Forms

Do not email forms; Fax (x66596) or Intercampus Only

• Anthem BlueCross Member Grievance Form
• Blue Shield of California Grievance Form
• LLUHC Patient Relations Incident Form
• Patient Rights & Responsibilities - Signs for LLUHC Waiting Room
• PSM - Provider Status Memo Form
• United Healthcare Appeal and Grievance Form
• UnitedHealthCare Grievance Form -  English  |  Spanish  |  Chinese

Resources

• Agency for Healthcare Research and Quality
• QUADA
• California Hospital Association
• California Medical Association (California Physicians Legal Handbook)
• Centers for Medicare & Medicaid Services (CMS)
• CMS-QPP
• Corporate Compliance Department
• Institute for Healthcare Improvement
• Integrated Healthcare Association
• Midas Electronic Event Reporting - Administrator
• Midas Electronic Event Reporting - Submission - Staff
• Midas Electronic Event Reporting
• Training Video - Managers