Pear Suite’s CHW Documentation and Billing Training Series
An overview of Pear Suite’s three-part training series designed to help CHWs understand covered services, recognize non-billable activities, and document services correctly.
Table of Contents
Pear Suite’s CHW Documentation and Billing Training
An overview of Pear Suite’s three-part training series designed to help CHWs understand covered services, recognize non-billable activities, and document services correctly.
Helpful Does Not Always Mean Billable
CHWs support members with many needs and resources within their role and scope. Everyday activities such as reminders, applications, transportation support, and resource handoffs can make a meaningful difference. Because these activities are common and genuinely helpful, it can be easy to assume they are automatically billable.
However, helpful does not always mean billable. California Department of Health Care Services (DHCS) requirements for Medi-Cal reimbursement are more specific. To qualify as a billable service under the Medi-Cal CHW benefit, an activity must address a health-related need, meet the requirements of a covered CHW service, and be supported by clear and complete documentation.
This is not about limiting the impact of CHWs. It is about understanding which services DHCS will reimburse and how to document those services correctly.
About the Training Series
Pear Suite’s three-part CHW Documentation and Billing Training helps CHWs:
- Understand which CHW services are covered
- Recognize activities that are not billable on their own
- Connect services to a member’s health-related need
- Avoid common billing and documentation mistakes
- Write clear, complete, and compliant activity notes
Each module includes a training presentation followed by a mandatory knowledge check. Select each section below to review the module and access its training materials.
Module 1: Understanding Covered CHW Services
This module introduces the four covered CHW service categories:
- Health Education
- Health Navigation
- Screening and Assessment
- Individual Support or Advocacy
CHWs will learn how health-related social needs connect to billable services and how to select the appropriate service category based on the support provided.
Complete Module 1
Module 2: Non-Billable Services and Common Billing Mistakes
CHWs regularly provide support that is helpful to members. However, not every activity qualifies as a covered or billable CHW service.
This module explains how to recognize non-covered activities, separate helpful support from billable services, and avoid common billing and documentation mistakes.
Examples of activities that may not be billable on their own include:
- Providing food, meals, or supplies
- General employment or career assistance
- Transportation arrangements
- Appointment reminders
- General application assistance
- Resource handoffs
- Clinical or counseling services outside the CHW scope
Some of these activities may support a broader covered CHW service. However, the service must be connected to a member’s health-related need, meet the requirements of a covered CHW service, and be documented appropriately.
Complete Module 2
📎 Non-Billable Services & Common Billing Mistakes — Training Module
📎 Non-Billable Services — Knowledge Check Quiz
Module 3: Documentation Requirements for CHW Services Title
An activity note should clearly explain why the CHW supported the member, what service was provided, and how the service addressed a health-related need.
This module reviews the required documentation elements, provides examples of strong and incomplete activity notes, and allows CHWs to practice applying the requirements to a realistic scenario.
Strong documentation should clearly identify:
- The member’s health-related need
- The CHW intervention or service provided
- The member’s response or the outcome
- The next steps or follow-up plan
Remember: If it is not documented, it did not happen. If it is not compliant, it is not billable.
Complete Module 3
📎 Documentation Requirements for CHW Services — Training Module
Knowledge Check Requirements
Each training module is followed by a mandatory knowledge check. A score of 100% is required to pass each quiz.
Complete the modules and knowledge checks in order:
- Review the training module.
- Complete the corresponding knowledge check.
- Review any questions answered incorrectly.
- Retake the knowledge check until you receive a score of 100%.
When Should You Complete This Training?
We recommend reviewing this training:
- When you are new to writing CHW activity notes
- Before submitting your first billable CHW activity
- When you need a refresher on covered services
- After receiving a compliance notification or documentation feedback
- Whenever you are unsure whether an activity is billable
Need Assistance?
If you have questions about the training, knowledge checks, covered CHW services, or documentation requirements, please contact your designated Customer Success Manager.