California State CHDP RESOURCES

CMC Enrollment Procedures (cmc enroll)...

Telecommunications Provider and Biller Application/Agreement (DHCS 6153) and the CHDP Telecommunications Provider and Biller Application/Agreement (DHCS 4431). ... files.medi-cal.ca.gov/pubsdoco/publications/masters-MTP/Part1/cmcenroll_z01.doc - 2009-12-08 

Where can you find additional resources on the CHDP Gateway program?   

• State DHS CHDP Gateway site: www.dhs.ca.gov/pcfh/cms/chdp/chdpgateway.htm
 
• Fact Sheet(s) on CHDP Gateway program: http://www.100percentcampaign.org
 
• Provider Training on How to Use the CHDP Gateway: The Department of Health Services is hosting statewide trainings for CHDP providers and their staff. For more information visit:   http://www.medi-cal.ca.gov/new_CHDP.asp
 
• DHS website of CHDP County Offices: http://www.dhs.ca.gov/pcfh/cms/chdp/directory.htm
 
• For a list of CHDP Providers in your area, contact your local CHDP Program Office:
    http://www.dhs.ca.gov/pcfh/cms/chdp/directory.htm
 
• Currently MRMIB is in the process of compiling all Enrollment Entities (EE) within the state.   This list should be available by early fall and posted on the MRMIB web-site:   http://www.mrmib.ca.gov
• http://files.medi-cal.ca.gov/pubsdoco/publications/Masters-Other/CHDP/userguide/gateway_guide.pdf
• http://files.medi-cal.ca.gov/pubsdoco/faq.asp
   

Medi-Cal - CHDP Batch file upload Step-by-Step User Guide  

• http://files.medi-cal.ca.gov/pubsdoco/publications/Masters-Other/CHDP/userguide/gateway_guide.pdf
 

School Forms  

• PM171A Report of Health Examination for School - English Version
 

• PM171A Informe del Examen de Salud Para El Ingreso a la Escuela
 

• PM171B (School Exam Waiver)
 

• PM171B (School Exam Waiver)