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Participating Provider Operations

The resources on this page contain useful self-service tools for participating providers to utilize when completing various operational tasks.

Note: This page contains instructions for providers directly contracted with Health Net, often termed "Direct Network". Direct Network providers are not contracted with a PPG.

For larger volume requests (more than 10 practitioners), please email DNPNM_DVP@healthnet.com for further direction.

For smaller volume requests (10 practitioners or less), follow these directions.

Provider Data Update Directions

For Add to Group (ATG) requests, please fill out our online form, or follow these directions:

  • Send email to Health Net Provider Data Coordination at DNPNM_DVP@healthnet.com
    • Email Subject: Medical/BH - ATG - Contract TIN - Practitioner NPI
  • Include the following documents as separate PDF documents, with the associated naming conventions
    (Note: one PDF with all documents will require resubmission):
  • Submit 1 email for each practitioner add request
Add To Group Request Documents
DocumentNaming ConventionExample filename
Practitioner Add Form (PDF)​ATG_CONTRACT TIN_PRACTITIONER NPIATG_123456_9876543
W-9​W9_CONTRACT TIN_PRACTITIONER NPIW9_123456_9876543
Medi-Cal Training Attestation
(if applicable)​		MCL_TRAIN_ATTEST_CONTRACT TIN_PRACTITIONER NPIMCL_TRAIN_ATTEST_123456_9876543
Medicare Approval Letter
(if applicable)		MCARE_APPROVAL_CONTRACT TIN_PRACTITIONER NPIMCARE_APPROVAL_123456_9876543_
DHCS Letter of Approval
(if applicable)​		DHCS_APPROVAL_CONTRACT TIN_PRACTITIONER NPIDHCS_APPROVAL_CONTRACT_123456_9876543
License Renewal Copy
(if license is due to expire within 3 months of submission)		LICENSE_RENEWAL_CONTRACT TIN_PRACTITIONER NPILICENSE_RENEWAL_123456_9876543

  • Send email to Health Net Provider Data Coordination at DNPNM_DVP@healthnet.com
  • Email Subject: Medical/BH - RFG - Contract TIN - Practitioner NPI
  • Data Elements to include in body of email:
    • Name of practitioner(s)
    • Contracted TIN
    • Effective Date of termination
    • Impacted Address(es)

  • Send email to Health Net Provider Data Coordination at DNPNM_DVP@healthnet.com
  • Email Subject: Medical/BH - Demo - Contract TIN - Practitioner NPI
  • Data Elements to include in body of email:
    • Brief description of change request
    • Name of practitioner(s)
    • Contracted TIN
    • Effective Date of the change
    • Impacted Address(es)
    • New address if applicable
      • Required: Phone number
      • If applicable: Fax number, Medi-Cal information (office hours, Gender limitations, Age limitations)
    • Attach updated W9
      • Naming Convention
        • W9_CONTRACT TIN_PRACTITIONER NPI
      • Example filename: W9_123456_9876543
Last Updated: 05/12/2026