Provider FAQs & Knowledge Base

Please have your license number and tax ID(s) on hand:

• Go to provider.healthnet.com.
• Select the Register button.
• Review Terms of Use, select I Agree to these terms.
• Select your region(s) and click Continue.
• Select your account type Physician.
• Once you select the type of provider, you'll be prompted to select your user type. Select Solo Practitioner.
• Enter your information into the form and click the Submit button.

In most cases, you'll be able to create your user name and password and log in to access the site immediately. Once you have successfully registered, you'll be able to check claims and eligibility, directly access policies and procedures, quickly locate providers in Health Net's referral network, and view evidence-based medicine guidelines and other clinical resources.

As a registered Physician, you may also create accounts for staff members who need to use provider.healthnet.com:

• Go to provider.healthnet.com and log in with your user name and password
• Select the My Account
• Select Create New User
• Select New End User option
• Fill out the registration form
• Create a user name
• Select the provider's information for this user
• If the user needs access to a specific tax ID, check the tax ID
• Select any additional functions for this user. Eligibility verification is standard
• If the user needs to conduct claims inquiries, check "Claims Inquiry"
• Click on the "Submit" button to create the account

Once complete, Health Net will send the new user a confirmation e-mail that will include their temporary password. Please notify the user of his or her new user name that you created on the registration form. For security purposes Health Net does not send the user name and password together.

As a registered Physician, you may also create a Delegated Administrator for your practice:

• Go to provider.healthnet.com and log in with your user name and password
• Select My Account
• Select Create New User
• Select Delegated Administrator option
• Fill out the registration form
• Create a user name
• Select the provider's information for this user
• If the user needs access to a specific tax ID, check the tax ID
• Click on the "Submit" button to create the account
• Once complete, Health Net will send the new delegated administrator account user a confirmation e-mail that will include their temporary password. You will need to notify this user of his or her new user name. For security purposes Health Net does not send the user name and password together.

Delegated Administrators can set up users for the organization and assign them roles. Due to security reasons, delegated administrator must establish an end user account for themselves in order to access patient-related information.

Please have your license number and tax ID(s) on hand:

• Go to provider.healthnet.com
• Select the Register button
• Review Terms of Use, select "I Agree to these terms" and "Continue"
• Choose your region(s) and "Continue"
• Select your account type:
  • Physician (click Delegated Administrator option)
  • Medical Group
  • Hospital
  • Ancillary Facility
• Enter your information into the form and click the "Submit" button to submit your request for verification
• Print out the confirmation message with your transaction ID and keep it in a secure location. The registrant will need the transaction ID to complete registration.
• Once your request is verified and approved, you will receive an email from Health Net with a link to complete registration with the specified transaction ID.

Delegated Administrators can set up users for their organization and assign them roles. Due to security reasons, delegated administrator must establish an end user account for themselves in order to access patient-related information.

Note: you must be a Delegated Administrator to perform this function

To Establish an End-User Account (Including Your Own):

• Log in to provider.healthnet.com using your user name and password
• Select My Account
• Select Create New User
• Fill out the registration form
• Create a user name
• Select the provider's information for this user
• If the user needs access to a specific tax ID, check the tax ID
• Select any additional functions this for this user. Eligibility verification is standard.
• If the user needs to conduct claims inquiries, check "Claims Inquiry"
• Click on the "Submit" button to create the account
• Once complete, Health Net will send a confirmation e-mail to the new provider user account that will include the temporary password. For security purposes Health Net does not send the user name and password together.

If you established an account for yourself, log out of the site and log back in with the new Provider User's user name and temporary password. You will now have access to additional features that are not available to you as the delegated administrator.

• Go to provider.healthnet.com
• Click the Log In button
• Enter the user name which was provided by your administrator and the temporary password received by email from Health Net
• Review Terms of Use, select "I Agree to these terms" and "Continue"
• Change password, please have a temporary password readily available
• Choose password hint question and create answer
• You will then be able to access and utilized provider.healthnet.com

Please contact your physician or delegated practice administrator to create your account access.

There are several different types of accounts for provider.healthnet.com: Physician, Hospital, Medical Group, or Ancillary Provider. Select the appropriate provider type and then you will be prompted to select a User type.

Most individual physicians will have immediate site access. In the event that a license or tax ID numbers does not match the numbers on file with Health Net, your registration will be performed manually with a goal to approve your request within two business days.

Requests for registration as a Hospital, Medical Group, Ancillary Provider or Physician Delegated Administrator must be processed and approved by Health Net. You will receive an email from us confirming that your account is approved. You will then be able to create your account user name and password. Our goal is to turn these around within two business days.

Delegated administrators may only administer accounts and assign access roles to other end users in your office. In order to access all functionality i.e. claims inquiry; you will need to give yourself access by registering yourself as an end user, after you have established your access as the delegated administrator.

• Log into provider.healthnet.com with your user name and password.
• Select My Account
• Select Create New User and fill out the on-line form to determine access rights.

Please contact Provider Services on-line for assistance or more information.

Please contact your delegated administrator. The delegated administrator may update your access with the following steps.

• Log into provider.healthnet.com with your username and password
• Select My Account
• Select Manage Users
• Search for the user account to update
• Click on the row of the account to edit
• Select the provider's information for this user
• If the user needs access to a specific tax ID, check the tax ID
• If the user needs access to specific provider(s) under the tax ID, select the "Individual Providers" checkbox
• Select a provider or multiple providers and use the right arrow button to move the selections to the right hand column
• Save changes

Please contact Health Net Provider Support.

Anyone can attempt to create an account, but all registrations are subject to Health Net verification. Registrants can't access the site until after they've gone through a stringent and secure approval process.

At this time, registration is limited to Health Net-participating providers. As a nonparticipating provider you only have access to pre-log in information.

If you are interested in participating with Health Net, please follow these steps:

• Select Working With Health Net
• Select Network Participation Request

• Select Provider Dispute Resolution Process

HN MediCal Encounter Data Toolkit (PDF)

• Log on to provider.healthnet.com with your username and password
• Select Patient Info
• Select one of three search options: member ID, member SSN, or member name
• Based on the search type you selected, enter the appropriate required fields
• Select Search

Please contact us for assistance with "System Error" messages.

Log on to provider.healthnet.com with your user name and password and follow the steps below:

• Once logged in, select Patient Info
• Select one of three search options: member ID, member SSN, or member name
• Based on the search type you selected, enter the appropriate required fields
• Select Search
• Select the appropriate member if more than one member is on the policy. Once in the member's eligibility screen, select the three-character code located under the Plan ID field
• After selecting the Plan ID code, the Web site displays a PDF of the member's Schedule of Benefits

Providers serving Employer HMO, PPO, EPO, Medicare Advantage plans, Medi-Cal, and Cal MediConnect.

Log-in to provider.healthnet.com

1. Log in with your username and password
2. Select Transactions
3. Select Claims
4. Select Check Claim Status
5. Enter in the member's subscriber ID
6. Select the appropriate tax ID number for the claim and then select Search

Providers serving IFP Commercial and Individual Medicare Advantage plans.

Log-in to provider.healthnetcalifornia.com

1. Log in with your username and password
2. Click Claims button on the top ribbon
3. Click Individual tab

• For additional help, you will find a provider portal manual at the lower left corner.

Please contact us for assistance with "System Error" messages.

The Delegated Administrator must assign access to these functions. Please contact your Delegated Administrator for assistance. If you already have access to these functions, refer to the next question for more information on locating these online.

• Log on to provider.healthnet.com with your username and password
• Select Transactions
• Select Check Authorization Status
• Locate member by selecting: member ID, member SSN, member name, or by authorization number
• Enter the required information based on the search type you selected
• Select Search
• A list of authorizations appears

Please contact us for assistance with "System Error" messages.

If you have forgotten the password or are locked out of your online account, you can contact us.

• Log on to provider.healthnet.com with your username and password.
• Select My Account.
• Click on the Email Address field under Profile.

Note: You must be a Delegated Administrator to perform this function.

To Update Access on an End-User Account:

1. Log in to provider.healthnet.com using your user name and password.
2. Select My Account.
3. Select Manage Users.
4. Search for a user, or click on View All Provider Accounts.
5. Roll the cursor over the end user account and click the edit icon.
6. Select or unselect any additional functions for this user. Eligibility verification is standard.
7. Click on the Submit button to update the account.
8. Once complete, the updates will be reflected the next time the end user logs in.