Data Exchange Workflow

1. Health Net creates member identification file for county
2. Health Net loads file to sFTP site by the 5th calendar day
3. Third-Party Entity performs member match
4. Third-Party Entity creates file as per Third-Party Entity to managed care plan file layout with Health Net member matches
5. Third-Party Entity loads file to sFTP site by the 19th calendar day
6. Health Net loads file into internal systems
7. Health Net creates file as per managed care plan to Third-Party Entity file layout for members matched with Third-Party Entity
8. Health Net loads file to sFTP site by the 22nd calendar day
9. Third-Party Entity downloads files (within 14 days or files are archived)

No files uploaded after the 19th day of the month will be used for that month's report cycle. If you miss that due date or have errors in your file(s), you must wait for the next monthly cycle.

Available Outbound Files for Third-Party Entities

• Demographic – Complete member demographic details, including date of birth, address, and phone numbers.
• Eligibility – Program names and current eligibility status for each member.
• Enrollment – Effective enrollment dates and associated site information.
• Open Referrals – Details on active clinical referrals, including related CPT codes.
• ECM/CS – Indicates whether a member is active with an Enhanced Care Management (ECM)/Community Supports (CS) provider, assigned provider details, and engagement status (e.g., Outreach, Enrolled, or Disenrolled).