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Important News from Health Net
View Provider Q & A (pdf)
Effective December 11, 2009, UnitedHealthcare completed the acquisition of Health Net of the Northeast's (HNNE's) licensed subsidiaries (Health Net of Connecticut, Inc., Health Net of New York, Inc., Health Net Insurance Company of NY, Inc., and Health Net of New Jersey, Inc.), and obtained rights to renew Health Net's membership in Connecticut, New York and New Jersey.
To ensure a seamless transition, Health Net has entered into an administrative services agreement with UnitedHealthcare through which Health Net will continue to manage the existing business in the HNNE subsidiaries on behalf of UnitedHealthcare until those clients enroll with UnitedHealthcare, another carrier or drop coverage. This means that Health Net continues to be responsible for all administrative functions, other than contract renewals, to members and providers, including claims payment, provider relations, provider services, prior authorizations, concurrent reviews, recredentialing, appeals and grievances, and member services for all business enrolled in Health Net benefit plans until Health Net members enroll with UnitedHealthcare or another carrier or drop coverage. Subsequently, Health Net will continue to manage claims and other administrative functions through the claims run-out period. UnitedHealthcare and Health Net are working together to ensure full continuity of both members' coverage and providers' reimbursement during the time that the Health Net benefit policies remain in force under existing Health Net contracts.
Health Net's current provider agreements remain in effect. The terms and compensation under your Health Net agreement apply to services you provide to Health Net members. Providers do not need to sign a new contract with UnitedHealthcare to continue to see Health Net members.
Since this transaction has closed, UnitedHealthcare now owns HNNE's licensed subsidiaries and will assume responsibility for contract renewals.
Health Net's contracted vendors for specialty management services - Quest Laboratories, CareCore National, Landmark Healthcare, OrthoNet, and Doral Dental - will continue to provide services to Health Net members.
Health Net Providers Not Currently Contracting with UnitedHealthcare
Health Net participating providers who are not currently participating with UnitedHealthcare who are interested in joining the UnitedHealthcare network can contact UnitedHealthcare at (877) 842-3210.
UnitedHealthcare and Health Net are working closely to renew existing Health Net commercial plans' customers in Connecticut, New York and New Jersey into the UnitedHealthcare or Oxford plan that is most comparable to their current Health Net plan as those customers reach their annual renewal dates. Members who renew coverage with UnitedHealthcare - either into a UnitedHealthcare or Oxford plan - will receive a new identification card and have access to all that UnitedHealthcare has to offer.
Health Net of Connecticut, Inc.'s Medicare Advantage (MA) and Part D prescription drug plan members who are enrolled in a Health Net plan for 2010 will continue to be served by Health Net under the terms of that plan. As with all privately insured Medicare programs, 2011 plan benefits will be filed with the Centers for Medicaid and Medicare Services (CMS) during 2010, and made public after CMS approval.
Health Net of New Jersey, Inc.'s Healthy Options (NJ Medicaid/Family Care) plan will be transitioned to UnitedHealthcare's AmeriChoice plan upon approval by the Division of Medical Assistance and Health Services (DMAHS). Healthy Options members will be notified prior to the transition date of their option to either remain with AmeriChoice or select another health plan. Those members who choose to remain with AmeriChoice will automatically be transitioned and will receive an AmeriChoice ID card.
The UnitedHealthcare acquisition of Health Net's Northeast licenses and rights to renew membership does not affect your TRICARE provider contract.
For additional information regarding the acquisition, refer to the Frequently Asked Questions (FAQs), developed to address provider concerns about the acquisition.
Health Net and UnitedHealthcare representatives are available to assist providers with any questions regarding contract status, billing, member coverage, and continuity of care. UnitedHealthcare and Health Net will continue to keep providers informed of operational process changes that may be necessary.
For additional questions, contact your Health Net Provider Network Management representative, or UnitedHealthcare at (877) 842-3210.
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