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Welcome Health Net Providers
On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact "a substantial proportion of people in America" and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions.
Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 866-262-5342 regarding any questions.
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Provider Training Webinars and Other Provider-Related Resources
Welcome to Health Net's trainings and resources page for our participating providers!
Renewed Agreement with Community Medical Centers
On January 1, 2023, Health Net, on behalf of CalViva Health, renewed a long-term agreement with Community Medical Centers. The partnership allows CalViva Health Medi-Cal members to continue to access critical services available from this large hospital system. Patients who have chosen CalViva Health as their Medi-Cal plan continue to have full access to all Community Medical Centers’ facilities.
Health Education Material Order Form
Access the order form for Health Net, CalViva Health, and Community Health Plan of Imperial Valley by scanning the provided QR code.
COVID-19 Updates
Behavioral Health Services Transition from MHN to Health Net
Effective January 1, 2024, behavioral health services will no longer be administered by MHN and will be transitioned to Health Net of California, Inc. (Health Net).
2023 Provider Appointment Availability Survey
We are excited to recognize our Survey Champions for achieving consecutive two-year performance goals in both urgent and non-urgent appointment availability. Visit our dedicated page where we proudly display the names of those who excelled in our recent survey.
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Change Healthcare Outage
2024 DHCS Targeted Rate Increase for Select Medi-Cal Services
Evolent Specialty Services, Inc.
Health Net has contracted with Evolent Specialty Services Inc. for radiology benefit management.
For Commercial HMO/PPO/POS and Ambetter HMO/PPO, prior authorization is required for the following outpatient radiology procedures: CT/CTA/CCTA, MPI, MRI/MRA, MUGA scan and PET scan. To obtain authorization through Evolent, visit Rad MD website.
2024 DHCS Medi-Cal Contract Award Q&As & Resources
CalAIM Updates for Medi-Cal Providers
CalAIM (California Advancing and Innovating Medi-Cal) is a multi-year initiative by DHCS to improve the quality of life and health outcomes of our population by implementing broad delivery system, program and payment reform across the Medi-Cal program.
D-SNP resources for providers
Provider Quality Improvement
Resources for you
- Site of Care Optimization for Therapeutic Infusions (SCOTI)
- Public Health Advisories & Notices
- Overview of Health Net's Delegation Model (PDF)
- Additional Resources
- Pharmacy Prior Authorization Guidelines
- County/City Resources Referral Forms
- Forms & Brochures
- Medical Necessity Criteria
- Medi-Cal Rx Prior Authorization Reinstatement Webinar
- Medical Policies – Commercial and Medi-Cal
- Medical Policies – Medicare
- Medicare Pre-Auth
- Open Negotiation Notice – No Surprises Act
- Payment Policies
- Pharmacy
- Population Needs Assessment Report (PDF)
- Submit Claims
Provider Support
Last Updated: 10/10/2024