IMPORTANT: Changes to Medi-Cal rules are coming! Medi-Cal will be available to all people who are 50 years of age or older who meet all Medi-Cal eligibility criteria, and immigration status will not matter. These changes will also let people keep more property and qualify for Medi-Cal. Go to benefitscal.com or call the Los Angeles County Department of Public Social Services at 1-866-613-3777.

doctor filling out paperwork at her desk

Need to Find a Form or Glance at Guidelines?

Here's your one-stop shop for L.A. Care provider manuals and commonly used forms.

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.

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

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

Prescription Drug Prior Authorization Request Forms
Provider Portal Resources