RESOURCES Forms, Manuals, Physician Training & Tools

Click on desired Adobe pdf document to open and download:


Authorization Forms
Senior Annual Health Assessment/Encounter Forms
Claims Forms
Manuals
The documents listed below can be quite large and take a few minutes to download. Please be patient...
Newsletters
Influenza Resources
Grievance Forms
Clinical Practice Guidelines
We have provided clinical practice guidelines that have been reviewed by the SYNERMED's Quality Improvement Committee. You may find these guidelines helpful in managing care in common areas of everyday medical practice.
Health Education
  You may request information on how to request interpreter services and how to obtain a poster which is translated into LA County’s 10 threshold languages that will inform patients that they can receive interpretation services at no cost by calling SYNERMED's C & L Department @ (213) 437-4219 X 1467 or by clicking here to see the information and the poster that are available to you.
   
  STAYING HEALTHY ASSESSMENT TOOL
   
  • 0-3 Years old
  English | Spanish | Lao | Russian | Vietnamese | Chinese | Hmong
   
  • 4-8 Years old
  English | Spanish | Lao | Russian | Vietnamese | Chinese | Hmong
   
  • 9-11 Years old
  English | Spanish | Lao | Russian | Vietnamese | Chinese | Hmong
   
  • 12-17 Years old
  English | Spanish | Lao | Russian | Vietnamese | Chinese | Hmong
   
  • 18 Years and older
  English | Spanish | Lao | Russian | Vietnamese | Chinese | Hmong
 
Alcohol & Drug Abuse
Do You Know Someone Who Has a Drinking Problem
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Asthma
Controlling Your Asthma
English | Spanish
 
High Blood Pressure
  You Can Control Your High Blood Pressure
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Dental
Baby's Teeth
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Diabetes
Prevent Diabetes Problems
English | Spanish

You Have Diabetes
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Exercise / Physical Activity
Stay Active & Feel Better
English | Spanish

Every Body Is Made to Move
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Growing up Healthy
  • 0-2 Months old English Spanish Vietnamese
  • 3-4 Months old English Spanish Vietnamese
  • 5-6 Months old English Spanish Vietnamese
  • 7-9 Months old English Spanish Vietnamese
  • 10-12 Months old English Spanish Vietnamese
  • 13-15 Months old English Spanish Vietnamese
  • 16-23 Months old English Spanish Vietnamese
  • 2 Years old English Spanish Vietnamese
  • 3 Years old English Spanish Vietnamese
  • 4-5 Years old English Spanish Vietnamese
  • 6-8 Years old English Spanish Vietnamese
  • 9-12 Years old English Spanish Vietnamese
  • 13-16 Years old English Spanish Vietnamese
 
Family Planning
  Call for details
 
HIV Prevention
  Call for details
 
Immunizations
After the Shots - What to do if your child
has discomfort
English | Spanish

All Kids need Hep B Shots!
English | Spanish
 
Injury Prevention
  Call for details
 
Nutrition
Be Healthy - Eat Five or More Fruits and Vegetables a Day
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Obesity / Weight Management
Embrace Your Health! Lose Weight if you
are Overweight
English
 
Parenting
  Call for details
   
Pregnancy & Breastfeeding
Breastfeeding Resource Directory - 2008
 
Preventive Health Guidelines & Recommended Immunization Schedule for Adults
Preventive Health guidelines& Recommended Immunization Schedule for Adults
English | Spanish
 
Preventive Health Guidelines & Recommended Immunization Schedule for Children and Adolescents
Preventive Health Guidelines & Recommended Immunization Schedule for Children and Adolescents
English | Spanish
 
Sexually Transmitted Disease (STD's) Prevention
STD Prevention
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Staying Healthy Tip Sheets
0-3 Years old
English
| Spanish | Armenian | Chinese | Farsi | Hmong | Korean | Tagalog | Russian | Vietnamese

4-8 Years old
English | Spanish | Armenian | Chinese | Farsi | Hmong | Korean | Tagalog | Russian | Vietnamese

9-11 Years old
English | Spanish | Armenian | Chinese | Farsi | Hmong | Korean | Tagalog | Russian | Vietnamese
12-17 Years old
English | Spanish | Armenian | Chinese | Farsi | Hmong | Korean | Tagalog | Russian | Vietnamese
18 Years and older
English | Spanish | Armenian | Chinese | Farsi | Hmong | Korean | Tagalog | Russian | Vietnamese
 
Smoking Prevention and Cessation
You Can Stop Smoking
English | Spanish | Armenian | Chinese | Farsi | Korean | Khmer | Russian | Tagalog | Vietnamese
 
Tuberculosis
  Call for details  
 
Upcoming Member Classes
  What To Do When My Child Gets Sick
 
Culture & Linguistics
  • Click here to download Referral Request Form.

  • Interpretation Services Poster

    A translated poster informing patients that they can receive interpretation services at no cost must be posted in visible areas in your office (i.e. reception desk, waiting room, exam room, etc.). This poster is translated into LA County’s 10 threshold languages and will inform patients that they can receive interpretation services at no cost. Click here to download a copy of the Free Interpreter Services Poster.

  • Click here to download Request Refusal Form.

  • Click here to download Staff Language Capabilities Form.

  • Click here to download Policy & Procedure QMP 128, "Cultural & Linguistic Services".

Physicians Training & Tools
CMS has changed its payment methodology to Health Plans. As such in order to maximize the revenue to the plan our providers need to code properly. The providers need to pay special attention to CHRONIC ADDITIVE CONDITIONS. Therefore accurate chart documentation and diagnosis reporting now determines reimbursement. In other words accurate encounter data is crucial. Below is a training aid for you and your staff to ensure you are coding correctly.
Member Resources
Health Plan Contact Information for all Client/Medical Groups
  • Molina Health Plan After Hours authorization line (800) 357 0163
    Website: www.molinahealthcare.com

  • LA Care Health Plan After Hours authorization line (877)-431-2273
    LA Care Nurse Advise Line for Healthy Families & Healthy Kids (800) 249-3619
    Website: www.lacare.org

  • Care 1st Health Plan After Hours authorization (800) 468-9935
    Website: www.care1st.com

Explanation of Coverage (EOC) Websites of Health Plans Miscellaneous
Health Plan Incentives for Primary Care Providers
Miscellaneous Forms
Copyright © 2007 SynerMed.
All Rights Reserved.
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