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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.
2022 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.
National Imaging Associates, Inc. (NIA)
Health Net has contracted with National Imaging Associates Inc. (NIA) for radiology benefit management.
For Commercial HMO/PPO/EPO/POS/HSP 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 NIA, visit RadMD.com.
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.
Provider Quality Improvement
Resources for you
- Dementia Care Awareness Training List (XLSX)
- Site of Care Optimization for Therapeutic Infusions (SCOTI)
- Special Supplemental Benefits for Chronically Ill Attestation
- 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
- Medi-Cal Rx Prior Authorization Reinstatement Webinar
- Medical Policies
- Medicare Pre-Auth
- New Provider Welcome Packets
- Open Negotiation Notice – No Surprises Act
- Pharmacy
- Population Needs Assessment Report (PDF)
- Submit Claims
- Timely Access to Care Training (PDF)
- WPATH Training Materials
- WPATH Training Course Information