The Enhanced Care Management (ECM) provider is required to submit claims for the provision of ECM-related services to the Plan using the national standard specifications and code sets to be defined by Department of Health Care Services (DHCS) as evidence of all ECM services provided to ECM members. The DHCS Coding guidance is found on DHCS’ website. This ensures that the Plan can effectively monitor the volume and frequency of ECM service provision and shows the true cost of providing ECM services to the Plan and DHCS. Paper claims may be submitted using the CMS 1500 form or UB-04 in accordance with standard guidelines. For fastest delivery and processing, claims can be submitted electronically using the HIPAA 5010 standard 837I (005010X223A2) and 837P (005010X222A1) transaction. Each claim submitted must include all mandatory elements and situational elements, where applicable. In the event the ECM provider is unable to submit claims to the Plan for ECM-related services using the national standard specifications and DHCS-defined code sets, the ECM provider can submit an invoice to the Plan with a minimum set of data elements (to be defined by DHCS) necessary for the Plan to convert the invoice to an encounter for submission to DHCS. For more details, go to DHCS’ website. Invoices can be submitted by via mail, email, fax and web. For more information on claims submission and payment, refer to the CalAIM Resources for Providers .