Enhanced Care Management (ECM) and Community Supports Provider Referrals

Providers or requesting entities may refer members to Enhanced Care Management and Community Supports services using the following methods.

Provider Portal referral

Registered providers can log in to the secured Alliance Provider Portal to submit, inquire about, cancel or add additional information to existing referrals.

Online referral on our website

Alliance providers can submit referrals for Enhanced Care Management or Community Supports by completing the appropriate form.

ECM referrals

• Adult ECM Provider Referral Form (age 21 and over)
• Youth ECM Provider Referral Form (age 20 and under)

CS referrals

• Housing
• Environmental Accessibility and Adaptability
• Meals
• Personal Care and Home Maker Services and Respite Services for Caregivers

Tus Xov Tooj

Refer a member to ECM/CS services by calling 831-430-5512.

Submit a Treatment Authorization Request (TAR) form

Submit a TAR form requesting the services and attach appropriate documentation. TAR forms can be submitted via:

• Xa email tuaj rau to [email protected]
• Fax to 831-430-5819.

Tips for a successful referral

• When referring a member for Community Supports, please include any relevant social information. When referring a member for ECM services, always include a population of focus. Check back on this page for updated information as we roll out additional populations of focus.
• Referrals are a “no wrong door” approach. We accept all incoming referrals.

Processing referrals and turnaround times

The Alliance processes submitted ECM/CS referrals within 5 business days, after which we will contact the referrer to let them know the outcome of the referral.

There are three possible outcomes:

1. The referral is approved: Correspondence is sent to the servicing and requesting provider.
2. The referral is denied: Correspondence is sent to the servicing and requesting provider, and a notice is sent to the member. This may happen if the member does not meet the criteria to be referred, or does not fit into one of the ECM/CS populations of focus.
3. The referral is void: This only occurs if there is not enough information to process the referral. The Alliance ECM team will make attempts to obtain the missing information. Once the authorization has been pending for five business days with no additional information provided, it is voided. Correspondence is sent to the servicing and requesting provider.