Become a D-SNP Provider
Why Join?
When you join the Community Health Plan of Imperial Valley (CHPIV), you join a network of providers dedicated to providing accessible, quality health care guided by local innovation. Together, we work to achieve our vision of A Community of Service, supporting optimal health outcomes, One Member at a Time.
Become a D-SNP Provider
The CHPIV is proud to announce that our Community Advantage Plus (HMO D-SNP) will be effective Jan. 1, 2026! We invite our provider network to become Dual Eligible Special Needs Plan (D-SNP) providers and help us continue to provide accessible, quality health care guided by local innovation.
You can start the process to become a CHPIV D-SNP participating provider right now! The CHPIV Provider Relations team is available to meet with you in person, virtually or by phone. Reach out to the CHPIV’s Provider Relations Department to begin contracting.
What is a D-SNP?
DHCS’ CalAIM program now requires all Local Health Plans of California to offer an exclusively aligned enrollment D-SNP by Jan. 1, 2026. A D-SNP is a type of Medicare Advantage plan specifically designed for individuals who are eligible for both Medicare and Medi-Cal.
D-SNP FAQs for Providers
You can start the process to become an Community Health Plan of Imperial Valley (CHPIV) D-SNP participating provider right now! The CHPIV Provider Relations team is available to meet with you in person, virtually or by phone. Reach out to the CHPIV’s Provider Relations Department to begin contracting. Your agreement will become effective Jan. 1, 2026.
The section below includes answers to frequently asked D-SNP questions for providers.
No. CHPIV providers are not automatically enrolled as D-SNP providers. However, they do have the option to participate in the CHPIV D-SNP network. If a provider chooses not to join the CHPIV D-SNP network, they will be considered out of network for CHPIV D-SNP members.
No, providers who have opted out of Medicare cannot participate. To join the CHPIV D-SNP network, providers must be enrolled in Medicare and accept assignment. Providers do not need to be enrolled in Medicare if they do not see Medicare beneficiaries, including CHPIV D-SNP members.
If a provider has opted out of enrolling in Medicare and decides they’d like to be in the CHPIV D-SNP network, they will need to opt in to Medicare and accept Medicare assignment prior to contracting with the CHPIV for the D-SNP program.
The CHPIV is required to credential our D-SNP providers. The CHPIV will follow the required credentialing process for Medicare Advantage providers. If you are already credentialed by the CHPIV for Medi-Cal, you will be required to credential for the D-SNP program.
The CHPIV is actively collaborating with local and regional SNF partners to expand access to SNF services. D-SNP members will receive intensive care coordination before, during and after SNF stays. This comprehensive approach aims to enhance access and streamline the experience for members requiring facility-based services.
The CHPIV’s care management team will support members across all care settings, ensuring continuity and quality of care. For short-stay residents, the care management team will assist with transitions, such as discharging to home or other settings, while also helping to place on hold and reactivate community services as needed. For long-term residents in skilled nursing facilities, care managers will collaborate closely with the facility staff to ensure member preferences are clearly communicated and that the appropriate plan services are effectively implemented.
Yes. Medicare covers mental health and substance use disorder services. Services include individual and group therapy, family counseling, psychotherapy for crisis, diagnostic tests, inpatient hospitalization, partial hospitalization, intensive outpatient services, substance use disorder treatment, medication-assisted treatments through opioid treatment programs or office-based settings, and more. Depression screenings are offered to patients at no cost through annual wellness visits.
MFTs must enroll in Medicare to be able to serve Medicare recipients and accept reimbursement.
- CHPIV D-SNP members will have access to both Medicare and Medi-Cal benefits. The CHPIV will coordinate all a member’s benefits between the Medicare and Medi-Cal programs.
- In addition, the CHPIV D-SNP will offer supplemental or extra benefits not provided through either Medi-Cal or traditional Medicare.
Beginning Jan. 1, 2026, the CHPIV D-SNP will provide the equivalent of Medi-Cal Enhanced Care Management (ECM) services called California Integrated Care Management (CICM). Members enrolling into the D-SNP will receive CICM services in place of the ECM services received under Medi-Cal.
Providers will be reimbursed in accordance with the Medicare Physician Fee Schedule.
There is no difference, as Part A and Part B services are standard regardless of age.
Yes. Providers can be both Medicare FFS and D-SNP providers.
Medicare Advantage plans, including D-SNPs, generally do not cover non-emergent or non-urgent care outside their service areas. However, the CHPIV is exploring the possibility of offering a travel benefit. More details will be shared in the coming months as plans develop.
Yes. As a member of our D-SNP network, all providers must participate in the Model of Care (MOC) training that is deployed each year. All providers and staff that care for members enrolled in special needs plans (SNPs) must complete and attest to such training.