Manuals and Forms

Provider Manuals

 

To help you better understand our guidelines, policies and procedures, L.A Care issues a manual to its providers each year. You can review a PDF version by selecting the appropriate manual on the Resources links.

 

Provider Forms

 

Below are the most frequently requested forms for L.A. Care Providers. If you have a suggestion for how we can improve any of the available forms, please contact Provider Support.

Behavioral Health Forms
Case Management Forms
Disease Management Forms
Employee Language Skills Self-Assessment Form
Initial Health Assessment Forms
Interpreter Poster
Member Demographic Data Report
Patient Interpreter Services Labels

Preferred Language Labels (Sized for Avery 5160)
Interpretation Request/Refusal Labels (Sized for Avery 5160)

Pharmacy & Formulary Forms
Prescription Drug Prior Authorization Request Forms
Provider Portal Resources