Provider Manual
The Enhanced Care Management (ECM) benefit is a statewide benefit established by the Department of Health Care Services (DHCS) to provide a whole-person approach to care that addresses the clinical and non-clinical circumstances of high-need Medi-Cal beneficiaries enrolled in Medi-Cal managed care. ECM is a collaborative and interdisciplinary approach to providing intensive and comprehensive care coordination/care management services to Populations of Focus.
Health Net, CalViva Health, and Community Health Plan of Imperial Valley are regulated by the California Department of Health Care Services (DHCS) and the California Department of Managed Health Care (DMHC). The Health Net, CalViva Health, and Community Health Plan of Imperial Valley Medi-Cal plans are offered by Health Net, CalViva Health, and Community Health Plan of Imperial Valley under a contract with the DHCS.
CalViva Health contracts with DHCS to provide services to Medi-Cal managed care members under the Two-Plan model in all ZIP Codes in Fresno, Kings and Madera counties. The Operations Manual for CalViva Medi-Cal providers in Fresno, Kings and Madera counties is developed and maintained for CalViva Health by Health Net.
Community Health Plan of Imperial Valley contracts with DHCS to provide services to Medi-Cal managed care members under the Single-Plan model in Imperial County. The Operations Manual for Community Health Plan of Imperial Valley Medi-Cal providers in Imperial County is developed and maintained for Community Health Plan of Imperial Valley by Health Net.