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Enhanced Care Management
Provider Manual
Introduction
Claims Submission
Billable ECM Services
Non-Billable Services
ECM Member Eligibility, Assignment and Enrollment
Continuity of ECM Services for Members Who Change Managed Care Plans
Data to Support ECM
ECM Core Services
ECM Eligibility Criteria
ECM Exclusion Criteria and ECM Overlapping Programs
ECM Service Provision Expectations
Member Discontinuation
Member Enrollment/Initiation of Delivery of ECM Services
Methods to Identify Potentially Eligible Members
Outreach and Member Engagement
Program Completion
Whole Person Care/Health Homes Program Transition
Getting Ready for ECM: The ECM Provider and Care Team
Contracting
Medi-Cal Enrollment/Vetting for ECM Providers
Provider Certification
Provider Experience and Qualifications
Staffing, Provider Capacity and Training
Payment to Providers
Quality, Monitoring and Oversight
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CalViva Health Member Services Department
Community Health Plan of Imperial Valley Member Services Department
Health Net Member Services Department
Health Net Member Services Department
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Health Net Member Services Department
800-675-6110
Last Updated: 10/08/2026
