Health Industry Collaboration Effort

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View our Library Tutorial videos for information on how to browse and search the Library.

Looking for a final HICE document/template? They can be found in the Final HICE Documents folder - click here for a list of available documents for each HICE team: FINAL HICE DOCUMENTS.

FINAL HICE DOCUMENTS
Appeals and Grievances Improvement Team
Claims Standardization Team
Approved Claims Documents
Health plan-specific letter templates that used to be located in this area of the library can now be found in the Health Plan Specific Letter Templates library document section here.
CMS Provider Dispute Resolution (PDR) Process Documents
		File	Upload	Review
	Title	Size	Date	Date
	CMS_Qtr_ProvDispute_Rpt_Final_012019	23 KB	2/28/2019	2/23/2022
	HICE_CMS_PDR_101_Guide_Final_7.18.2024	653 KB	7/22/2024
Commercial Provider Dispute Resolution (PDR) Process Documents
Training Documents
Compliance Team
Compliance Team Delegated Entity (DE) Compliance Workgroup
Compliance Team IT Systems Integrity Workgroup
Credentialing Shared Audit Policy Team - Main / California
Credentialing Shared Audit Policy Team - Main / Mid-Atlantic
Credentialing Shared Audit Policy Team - Main / Mid-Atlantic / Northwest / Texas
Credentialing Shared Audit Policy Team - Main / Northwest
Credentialing Shared Audit Policy Team - Main / Texas
Cultural & Linguistic (C&L) Services Team
Cultural and Linguistics Provider Toolkit
Encounters Standardization Team
QI / UM Team - Main
Service Determination Standardization Team (SDS) - UM Templates & Tools
UM Required Reports Team (formerly QI and UM Required Reports Team)
UM Templates & Tools (1) - Health Plan-Specific Template Location
UM Templates & Tools (Commercial)
UM Templates & Tools (Medi-Cal)

HICE documents can be altered for use by organizations/other regions as needed; however, the HICE logo/any HICE references should be removed if the document is not being used in its original format. Documents available within the Library are intended to be used as printed documents. To the extent such documents are used digitally, it shall be the user's responsibility to ensure their use of the documents adheres to the accessibility standards applicable to their organization.

HICE is a voluntary 501(c)3 organization that includes participation by and advice from accrediting and regulatory agencies. The goal of HICE work products is to offer HICE participating organizations standardized tools and best practices toward optimizing efficiencies to implement health industry requirements. HICE heeds feedback from accrediting and regulatory agency partners regarding HICE work products; however, HICE does not obtain official regulatory approval for its work products. As such, HICE work products are not to be considered exempt from any approval process required by regulatory agencies.