1. Confirm the payer type first
Before anything else, decide whether the referral is Cal-AIM, ALW, private pay or another source. The payer type decides which steps follow, which documents you need and who you will be talking to.
Capture Medicare and Medi-Cal status, the beneficiary ID, and income details — including SSI and whether it will be paid to the facility for room and board.
2. Collect a complete referral packet
Most stalled admissions are waiting on one document. Agree on a required list and do not move forward until it is complete.
- Face sheet
- History & physical (H&P)
- Current medication list
- LIC 602 physician's report
- TB test, conservatorship papers and Medi-Cal eligibility where relevant
3. Match the managed care plan
Each county has its own set of Medi-Cal managed care plans, and not every plan contracts for the same services. Check the patient's current plan against the plans that work for your facility.
If the patient is already on a plan you work with, skip ahead. If not, a plan switch is the next step — and it has its own waiting period.
4. Plan switch
Request the switch, record the date, and set a follow-up. Plan switches are where weeks quietly disappear, so the request date and expected effective date should be visible to the whole team.
5. Submit to the care coordination agency (CCA)
Send only complete packets. Incomplete submissions come back, and the clock restarts.
Log the submission date, who you sent it to, who was copied, and every reply.
6. Follow up, assess, write the ISP
After the CCA responds, schedule the assessment, then complete the individual service plan (ISP). Keep the EIN and other facility documents ready so the final steps don't stall on paperwork you already have.
7. Move-in — or a clear reason why not
Close every referral with an outcome. If a patient is marked do-not-admit, record the reason so a future referral for the same person raises a warning.
Where ALFIntake fits
ALFIntake runs every patient through these exact stages, pre-loads the plans for your city, tracks plan-switch and CCA dates, and turns each due date into a task for the right person.