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EDI


What is EDI?

CORE PhaseII Electronic data interchange (EDI) is the exchange of business transactions in a standardized format from one computer to another. Health Net of Arizona, Inc. Health Net of California, Health Net Health Plan of Oregon, Inc.and Health Net Life Insurance Company (Health Net) and providers use this technology to communicate claims, electronic remittance, claims payment, eligibility, and other information, providing a paperless and efficient process.

Quicker claims payment, confirmation reports, and elimination of paper and associated expenses are just a few of the reasons why nearly 80 percent of Health Net's claims are submitted electronically. EDI also gives you the tools you need to track electronic claims status, improve timely filing, and access daily accept/reject reports. This also means easier receivables and account reconciliation. By using Health Net-approved vendors and clearinghouses, HIPAA compliance is done for you, and you'll have automatic access to highly secure and time-tested solutions.

Health Net has the following transactions available for providers through one of our approved clearinghouses: 837 electronic claim submission, 835 electronic remittance advice, and EFT payments. We are CORE Phase III certified with our real-time claims status and member eligibility transactions as well as compliant with the federal operating rules.

View our payer ID numbers for more information.


Submit claims through a clearinghouse

Get Started
For successful EDI claim submission, you'll need to use electronic reporting made available by your vendor and/or clearinghouse. View our payer ID numbers for more information. Health Net returns claims acknowledgements back to the clearinghouse with notifications of acceptance or rejections of individual claims. Providers can review these reports to check the status of their submission.

Health Net processes anesthesia, medical, coordination of benefits (COB), hospital, and surgical claims electronically. We accept claims directly from Change Healthcare, MD-OnLine/Ability, Availity and more. Claims regarding other benefits, including certain mental health, complementary treatments, pharmacy, and outpatient radiology are administered for Health Net by outside vendors and claims are processed by each vendor accordingly.

Our partnership with MD On-line/Ability allows even the smallest practice to take advantage of EDI savings, for free. Using this web-based solution, you can submit direct to Health Net on-line.

Submit claims directly to Health Net (through MD Online)
In partnership with MD On-Line/Ability Network, Health Net now gives providers the option of exclusively submitting Health Net claims for free through a private label website that links directly from www.healthnet.com. The two products offered on the site allow providers to submit claims using either their own practice management software or direct data entry. The latter allows smaller practices to take advantage of the benefits of submitting claims electronically without having to bear the expense of specialized software. Providers may also use MD On-Line's services as an all payer solution for which standard MD On-Line fees apply.

MD ON-LINE

If you're just starting out, we'll walk you through the process. Contact one of Health Net's EDI experts for more information.


Support

Health Net's EDI specialists... on call for you
Whether you're signing up for EDI, giving it another try or working to increase your electronic claim volume, EDI specialists are just a phone call away.

Effective January 1, 2018, for questions on electronic claims or electronic remittance advice for Individual Family Plan (IFP), Medicare Advantage (MA) HMO and MA PPO member claims with dates of service (DOS) on or after January 1, 2018, contact:

Centene EDI Department
1-800-225-2573, extension 6075525
Or by email at: EDIBA@centene.com

The following providers can continue to contact Health Net EDI department by telephone at 1-800-977-3568 or by email at edi.support@healthnet.com:

  • Arizona, MA HMO employer group, HMO and/or PPO
  • California, MA HMO employer group, HMO, PPO (including EnhancedCare PPO for small business group), EPO, POS, Medi-Cal (including CalViva Health) and/or Cal MediConnect
  • Oregon, EPO, POS, PPO, CommunityCare, and/or Centene Corporation Employee Self-Insured PPO.

Tips and Terms

The following are some pointers about claims submissions, the HIPAA glossary of EDI terms and frequently asked questions (FAQs).

Here are some tips from our EDI specialists for successful claims submission:


Providers in Arizona, California, Oregon, and Washington

  • Submit claims with the patient's name and birth date exactly as it appears on their Health Net ID card.
  • Health Net processes medical, hospital, anesthesia, surgical, and emergency room (ER) claims electronically from both participating and nonparticipating providers.
  • Health Net encourages the electronic submission of all claims, including COB claims; however supporting documentation may be requested for the following types of claims: StopLoss, trauma and newborn NICU claims.
  • Avoid timely filing issues by understanding and regularly monitoring EDI reports from your vendor/clearinghouse. Always ensure that the claim was not only just sent but that it was also accepted by the payer. This will improve your turnaround for rejected claims to ensure they are reviewed and resubmitted in a timely manner.

Frequently Asked Questions

Can claims be paid faster if I submit them electronically?

Yes. Electronic claims are generally received in less time than those sent via the mail. Thus, processing time is often reduced.

Are there costs associated with electronic claims submission through a clearinghouse?

There are many options for electronic claim submission. Depending on the needs of your organization, there may be costs associated. Clearinghouses should be contacted directly so needs and options can be discussed.

In partnership with MD On-Line, Health Net now gives providers the option of exclusively submitting Health Net claims for free through a private label website that links directly from www.healthnet.com. The two products offered on the site allow providers to submit claims using either their own practice management software or direct data entry. The latter allows smaller practices to take advantage of the benefits of submitting claims electronically without having to bear the expense of specialized software. Providers may also use MD On-Line's services as an all payer solution for which standard MD On-Line fees apply.

What are the advantages of submitting my claims through a clearinghouse?

Submitting through a clearinghouse has many advantages including:

  • It is not necessary to test with Health Net. Clearinghouses are HIPAA compliant.
  • Payer reports are submitted electronically through the clearinghouse vs. being sent via mail.
  • Clearinghouses will make available to providers the initial acceptance report confirming receipt of your claims by your clearinghouse and the payer. Payer Acceptance/Rejection reports can be used as proof of timely filing.
  • Initial Acceptance Report: This report shows your clearinghouse accepted the EDI claim and forwarded it to Health Net for additional payer editing and processing. Please note that claims can pass clearinghouse edits but still be rejected by Health Net.
  • Health Net Reject Report: This report shows that Health Net rejected the claim for "invalid subscriber ID number." Please note that a claim that is filed and "rejected" is not considered "received" by Health Net. These claims should be corrected and resubmitted electronically as soon as possible to avoid timely filing issues.
  • Clearinghouses will notify providers of updates on changes in Health Net's electronic claim submission policies.
What if I am using a vendor/clearinghouse that is not on your list?

Many vendors/clearinghouses have agreements for transmitting EDI claims through other clearinghouses. Please contact your vendor/clearinghouse and verify connectivity to Health Net.

Can nonparticipating providers submit claims electronically?

Yes. All claims can be submitted electronically from both participating and nonparticipating providers. Click here to get started.

Talk to an
EDI Specialist

Contact Health Net’s Electronic Data Interchange (EDI) team at the email address below.

Get help from
Health Net’s EDI specialists
EDI.Support@healthnet.com
1-800-977-3568

Transfer Funds Electronically


Electronic Remittance Advice and Electronic Funds Transfer

Electronic Remittance Advice (ERA)
Health Net has further streamlined our business processes to improve claims procedures. Providers can now register to receive Electronic Remittance Advices (ERA). These features streamline claim processing, reduce administrative work and improve provider satisfaction by reducing claims-related problems.

ERA files give providers details regarding multiple claims. ERA improves providers' business office workflow by allowing the adjudicated claim information to be automatically posted to accounts receivable systems. Health Net will send an ERA to any provider who registers with Health Net and with a clearinghouse. ERA is available in all Health Net service areas.

Electronic Funds Transfer (EFT)
EFT automates the distribution of funds into providers' accounts using Automated Clearinghouse (ACH) processing. EFT is the electronic mechanism used to instruct Depository Financial Institutions (DFIs) to move money from one account to another. Many formats are available for the actual data in the electronic message, and different formats apply at each stage. EFT is safe, secure, efficient, and less expensive than paper check payments and collections. A separate registration form is required. Get help from Health Net's EDI specialists. Please contact the Health Net Provider Services Center regarding all claim adjudication issues regardless of submission method.

Effective January 1, 2018, Payspan Health® will provide EFT and ERA delivery service at no cost to Health Net providers serving individual Medicare Advantage (MA) and Individual Family Plan (IFP) members.

Payspan Health for individual MA and IFP

Existing ERA and EFT providers serving individual MA and IFP members who wish to continue receiving ERA and EFT are required to register with Payspan to obtain access to EFT and ERA delivery services.

If providers choose not to register with Payspan for individual MA and IFP claims payments, paper checks and remittance advices (RAs) will be mailed to the provider address on file for claims with dates of service on or after January 1, 2018.

A unique registration code is required for registration with Payspan. A registration code can be requested by any of the following methods:

Registration codes requested online or via email will be emailed from Payspan along with detailed registration instructions.

Employer group MA HMO, HMO, PPO and EPO; POS, CommunityCare, Centene Corporation Employee Self-Insured PPO, Medi-Cal (including CalViva Health) and/or Cal MediConnect

ERA and EFT require separate registration. 
You can register for just ERA, just EFT or both.


Register Online or Download Enrollment Forms

Register Online

Download Enrollment Forms


Payer IDs

Refer to the table below for payer identification (ID) information as indicated by dates of services (DOS).

Line of business Payer ID for dates of service on or before December 31, 2017 Payer ID for dates of service on or after January 1, 2018
ARIZONA
  • Allwell individual MA, and MA with Part D HMO, Special Needs Plan (SNP).(does not apply to employer group MA HMO)
  • IFP Ambetter
38309 68069
  • employer group MA HMO, HMO, PPO,CommunityCare HMO,
    Centene Corporation Employee Self-Insured PPO Plan
38309 38309
CALIFORNIA
  • Individual MA HMO, Special Needs Plan (SNP) (does not apply to employer group MA HMO)
  • IFP
95567 68069
  • employer group MA HMO, HMO, PPO, EPO, Point of Service (POS), Medi-Cal (including CalViva Health), Cal MediConnect, Centene Corporation Employee Self-Insured PPO Plan
95567 95567
OREGON / WASHINGTON
  • Medicare Advantage
95567 68069
  • EPO/PPO, Point of Service (POS), CommunityCare, Centene Corporation Employee Self-Insured PPO Plan
95567 95567

Talk to an
EDI Specialist

Contact Health Net’s Electronic Data Interchange (EDI) team at the email address below.

Get help from
Health Net’s EDI specialists
EDI.Support@healthnet.com
1-800-977-3568

Approved Vendor List


Approved Vendors List

Claims Submission

Health Net has contracted with Capario, Emdeon, and MD On-Line to provide claims clearinghouse services for Health Net claim submission. These partners will work with your clearinghouse or vendor to get the claims submitted to Health Net in a timely manner.

Benefits of electronic claim submission include:

  • Reduction/elimination of costs associated with printing and mailing paper claims.
  • Improvement of data integrity through the use of clearinghouse edits.
  • Faster receipt of claims by Health Net, resulting in reduced processing time and quicker payment.
  • Confirmation of receipt of claims by the clearinghouse.
  • Availability of reports when electronic claims are accepted and rejected.
  • Ability to track electronic claims, resulting in greater accountability.

Clearinghouse Telephone number Website Health Net payer ID
CA & OR AZ
Capario (now Emdeon) AZ, CA & OR
1-800-792-5256
www.capario.com 95567 38309
Emdeon 1-877-469-3263 www.emdeon.com 95567 38309
As a result of our partnership with MD On-Line, all payer claims can be submitted electronically via Health Net's website, HealthNet.com.
MD On-Line 1-888-499-5465 HealthNet.com
mdon-line.com
95567 38309

Reports

For successful EDI claim submission, providers/facilities must utilize the electronic reporting made available by their vendor/clearinghouse. There may be several levels of electronic reporting:

  • Confirmation/rejection reports from EDI vendor
  • Confirmation/rejection reports from EDI clearinghouse
  • Confirmation/rejection reports from Health Net

Providers may also check the status of paper and electronic claims via our claims status transaction available through Emdeon or online at HealthNet.com. Registration is required.

Providers are encouraged to contact their vendor/clearinghouse to see how these reports can be accessed/viewed. All electronic claims that have been rejected must be corrected and resubmitted. Rejected claims may be resubmitted electronically.

For questions regarding electronic claim submission, please contact Health Net’s dedicated EDI line:

California and Oregon: 1-800-977-3568
Arizona: 1-866-334-4638

Talk to an
EDI Specialist

Contact Health Net’s Electronic Data Interchange (EDI) team at the email address below.

Get help from
Health Net’s EDI specialists
EDI.Support@healthnet.com
1-800-977-3568

Using EDI for Eligibility & Benefits Verification


Using EDI for Eligibility & Benefits Verification

HIPAA Standard 270/271 Eligibility Transactions

Requests for eligibility status for a single commercial, Medicare or state health programs member transaction may be submitted by registered participating providers on the Health Net provider website. Select the appropriate Verify Eligibility link under Eligibility & Benefits to the left to get started.

To request eligibility and obtain eligibility information for multiple members at one time, providers can use the 270/271 eligibility transaction through one of two electronic clearinghouses. A 270 request provides eligibility verification information directly to providers through a real-time link. Providers submit a request for a single HIPAA standard 270 or multiple 270s and obtain the 271 responses from Health Net online.

271 responses are also compliant with the Council for Affordable Quality Healthcare (CAQH®)/Committee on Operating Rules for Information Exchange (CORETM) Phase II requirements.

In accordance with the Health Insurance Portability and Accountability Act (HIPAA) privacy requirements for submission of electronic health care transactions, Health Net is compliant in meeting and adopting the 270/271 eligibility transaction standards as outlined by HIPAA and with the Administration Simplication Operating rules for eligibility and health care claim status transactions. Check with your vendor/clearinghouse for sending/receiving eligibility requests using the 270/271 real time transaction or contact one of the Health Net clearinghouses listed below to set up the HIPAA standard 270 request:

Clearinghouse Contact Information Health Net payer ID
CA & OR AZ
MDOn-line/Ability 1-877-469-3263
www.mdon-line.com
95567 38309
TransUnion 1-877-732-6853
www.transunion.com/industry/healthcare
95567 38309
Change Healthcare 1-866-817-3813
www.changehealthcare.com
HNNC HNNC

Talk to an
EDI Specialist

Contact Health Net’s Electronic Data Interchange (EDI) team at the email address below.

Get help from
Health Net’s EDI specialists
EDI.Support@healthnet.com
1-800-977-3568

Using EDI for Capitated Encounter Submission

Using EDI for Capitated Encounter Submission

To comply with the requirements of the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), the California Department of Health Care Services (DHCS), the California Disproportionate Share Hospital Program (DSH), the Managed Risk Medical Insurance Board (MRMIB), and the National Committee for Quality Assurance (NCQA), Health Net requires information about use of health services by its members.

Capitated participating physician groups (PPGs), hospitals and ancillary providers are required to provide complete encounter data about professional services rendered to Health Net members. These services include office visits, X-rays, laboratory tests, surgical procedures, anesthesia, physician visits to the hospital, inpatient, outpatient, emergency room, out-of-area, or skilled nursing facility (SNF) services, and all professional referral services. Capitated participating facilities (and PPGs with dual-risk contracts) are required to provide encounter data monthly about institutionally based services rendered to Health Net members.

Encounter data submissions must include all member-paid cost share amounts, such as copayments, coinsurance and deductibles applicable to the member’s benefit. In addition, any rejected encounter data must be corrected and resubmitted in order for complete information and correct member-paid cost share amounts to be captured and accumulated. Encounter data submission is also an integral part of the Health Net Quality of Care Improvement Program (QCIP) (applicable only for HMO and Point of Service (POS) products) and Healthcare Effectiveness Data and Information Set (HEDIS®)*. Refer to the Quality Improvement (QI) topic for more information on QCIP.

Reporting of encounter data is extremely important. Health Net and its affiliated health plans are required to provide encounter data to regulatory agencies. The following procedures are required for encounter reporting:

  • Reporting of services must be on a per member, per visit basis, rather than a monthly summary. An accounting of all services rendered by date and member must be submitted to Health Net or Molina Healthcare, depending on the member’s health plan affiliation. The encounter data should be submitted via electronic transmission in the H ANSI 837 5010 X12 format through the encounter clearinghouse, TransUnion. Encounter records must include the same data elements as would be required on a fee-for-service (FFS) claim form.
  • Health Net does not accept encounter and encounter summary reports on paper or directly from capitated PPGs. Providers should forward electronic encounters only. For additional information about how to submit encounters electronically, refer to 837 5010 Professional and Institutional Standards (pdf), 837 Institutional Companion Guide (pdf) and 837 Professional Companion Guide (pdf).
  • All encounter reporting must identify members by their Health Net identification numbers. This number is on each member’s identification card. Submission of encounter data without the member identification number is not acceptable and is returned for correction.

Contact the Enc_Team@healthnet.com for assistance in developing or modifying procedures to accomplish complete encounter data submission.

*HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

Talk to an
EDI Specialist

Contact Health Net’s Electronic Data Interchange (EDI) team at the email address below.

Get help from
Health Net’s EDI specialists
EDI.Support@healthnet.com
1-800-977-3568

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Important Notice

General Purpose
Health Net's National Medical Policies (the "Policies") are developed to assist Health Net in administering plan benefits and determining whether a particular procedure, drug, service, or supply is medically necessary. The Policies are based upon a review of the available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the drug or device, evidence-based guidelines of governmental bodies, and evidence-based guidelines and positions of select national health professional organizations. Coverage determinations are made on a case-by-case basis and are subject to all of the terms, conditions, limitations, and exclusions of the Member's contract, including medical necessity requirements. Health Net may use the Policies to determine whether, under the facts and circumstances of a particular case, the proposed procedure, drug, service, or supply is medically necessary. The conclusion that a procedure, drug, service, or supply is medically necessary does not constitute coverage. The Member's contract defines which procedure, drug, service, or supply is covered, excluded, limited, or subject to dollar caps. The policy provides for clearly written, reasonable and current criteria that have been approved by Health Net's National Medical Advisory Council (MAC). The clinical criteria and medical policies provide guidelines for determining the medical necessity criteria for specific procedures, equipment and services. In order to be eligible, all services must be medically necessary and otherwise defined in the Member's benefits contract as described in this "Important Notice" disclaimer. In all cases, final benefit determinations are based on the applicable contract language. To the extent there are any conflicts between medical policy guidelines and applicable contract language, the contract language prevails. Medical policy is not intended to override the policy that defines the Member's benefits, nor is it intended to dictate to providers how to practice medicine.


Policy Effective Date and Defined Terms.
The date of posting is not the effective date of the Policy. The Policy is effective as of the date determined by Health Net. All policies are subject to applicable legal and regulatory mandates and requirements for prior notification. If there is a discrepancy between the policy effective date and legal mandates and regulatory requirements, the requirements of law and regulation shall govern. In some states, prior notice or posting on the website is required before a policy is deemed effective. For information regarding the effective dates of Policies, contact your provider representative. The Policies do not include definitions. All terms are defined by Health Net. For information regarding the definitions of terms used in the Policies, contact your provider representative.


Policy Amendment without Notice.
Health Net reserves the right to amend the Policies without notice to providers or Members. In some states, prior notice or website posting is required before an amendment is deemed effective.


No Medical Advice.
The Policies do not constitute medical advice. Health Net does not provide or recommend treatment to Members. Members should consult with their treating physician in connection with diagnosis and treatment decisions.


No Authorization or Guarantee of Coverage.
The Policies do not constitute authorization or guarantee of coverage of any particular procedure, drug, service, or supply. Members and providers should refer to the Member contract to determine if exclusions, limitations and dollar caps apply to a particular procedure, drug, service, or supply.


Policy Limitation: Member's Contract Controls Coverage Determinations.
Statutory Notice to Members: The materials provided to you are guidelines used by this plan to authorize, modify or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract. The determination of coverage for a particular procedure, drug, service, or supply is not based upon the Policies, but rather is subject to the facts of the individual clinical case, terms and conditions of the Member's contract, and requirements of applicable laws and regulations. The contract language contains specific terms and conditions, including pre-existing conditions, limitations, exclusions, benefit maximums, eligibility, and other relevant terms and conditions of coverage. In the event the Member's contract (also known as the benefit contract, coverage document, or evidence of coverage) conflicts with the Policies, the Member's contract shall govern. The Policies do not replace or amend the Member contract.


Policy Limitation: Legal and Regulatory Mandates and Requirements
The determinations of coverage for a particular procedure, drug, service, or supply is subject to applicable legal and regulatory mandates and requirements. If there is a discrepancy between the Policies and legal mandates and regulatory requirements, the requirements of law and regulation shall govern.


Reconstructive Surgery
California Health and Safety Code 1367.63 requires health care service plans to cover reconstructive surgery. "Reconstructive surgery" means surgery performed to correct or repair abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following:


1. To improve function; or
2. To create a normal appearance, to the extent possible.


Reconstructive surgery does not mean "cosmetic surgery," which is surgery performed to alter or reshape normal structures of the body in order to improve appearance.


Requests for reconstructive surgery may be denied, if the proposed procedure offers only a minimal improvement in the appearance of the enrollee, in accordance with the standard of care as practiced by physicians specializing in reconstructive surgery.


Reconstructive Surgery after Mastectomy
California Health and Safety Code 1367.6 requires treatment for breast cancer to cover prosthetic devices or reconstructive surgery to restore and achieve symmetry for the patient incident to a mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the copayment, or deductible and coinsurance conditions, that are applicable to the mastectomy and all other terms and conditions applicable to other benefits. "Mastectomy" means the removal of all or part of the breast for medically necessary reasons, as determined by a licensed physician and surgeon.


Policy Limitations: Medicare and Medicaid
Policies specifically developed to assist Health Net in administering Medicare or Medicaid plan benefits and determining coverage for a particular procedure, drug, service, or supply for Medicare or Medicaid Members shall not be construed to apply to any other Health Net plans and Members. The Policies shall not be interpreted to limit the benefits afforded Medicare and Medicaid Members by law and regulation.

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Upload No Review - Terms of Use

I have elected to upload a zipped folder of care coordination documents in a pdf format using the specified file naming convention as set forth below. I understand the importance of ensuring that the file names are accurate and that they accurately identify the member(s) that the care coordination document(s) is/are associated with. I elected to upload the attached documentation and confirm submission without utilizing the review option because the files were generated and named systematically, not manually, and/or the files have been carefully audited and confirmed to be accurately named. By confirming my upload, I am representing that the file(s) is/are named accurately.


Document Type - File naming convention
PPG Care Plans - careplan_hnsubidpersonid_yyyymmdd.pdf
CBAS Care Plan - cbascp_hnsubidpersonid_yyyymmdd.pdf
CBAS Assessment - cbasa_hnsubidpersonid_yyyymmdd.pdf
MSSP Assessment - msspa_hnsubidpersonid_yyyymmdd.pdf
MSSP Care Plan - msspcp_hnsubidpersonid_yyyymmdd.pdf
MSSP Connect the Needs Assessment - mctna_hnsubidpersonid_yyyymmdd.pdf
MSSP Connect the Needs Care Plan - mctncp_hnsubidpersonid_yyyymmdd.pdf
SNF MDS Form - snfmds_hnsubidpersonid_yyyymmdd.pdf
Note: hnsubidpersonid is the Health Net Subscriber ID and Person ID
File name example: careplan_R9999999900_20140505.pdf

Upload & Review - Terms of Use

I have elected to upload a zipped folder of care coordination documents in a pdf format using the specified file naming convention as set forth below. I understand the importance of ensuring that the file names are accurate and that they accurately identify the member(s) that the care coordination document(s) is/are associated with. I have elect to upload of the attached documents and confirm submission using the review option. I certify that the files will be carefully audited and confirmed to be accurately named before confirming my upload. By confirming my upload, I am representing that the file(s) is/are named accurately.


Document Type - File naming convention
PPG Care Plans - careplan_hnsubidpersonid_yyyymmdd.pdf
CBAS Care Plan - cbascp_hnsubidpersonid_yyyymmdd.pdf
CBAS Assessment - cbasa_hnsubidpersonid_yyyymmdd.pdf
MSSP Assessment - msspa_hnsubidpersonid_yyyymmdd.pdf
MSSP Care Plan - msspcp_hnsubidpersonid_yyyymmdd.pdf
MSSP Connect the Needs Assessment - mctna_hnsubidpersonid_yyyymmdd.pdf
MSSP Connect the Needs Care Plan - mctncp_hnsubidpersonid_yyyymmdd.pdf
SNF MDS Form - snfmds_hnsubidpersonid_yyyymmdd.pdf
Note: hnsubidpersonid is the Health Net Subscriber ID and Person ID
File name example: careplan_R9999999900_20140505.pdf

Terms of Use for 1 to 10 Individual Documents Upload

I have elected to upload a group of individual files by identifying and attaching up to 10 individual files. I understand that the files will be named based on the information I enter for each file and that the file name will identify the member that the care coordination document(s) is/are associated with. Additionally, I understand the importance of ensuring that the file(s) is/are named correctly. I certify that the files will be carefully audited and confirmed to be accurately named before confirming my upload. By confirming my upload, I am representing that the file(s) is/are named accurately.


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Care Coordination Download Terms of use

I am requesting to download care coordination documents on behalf of the Medical Group that I/we represent and the affiliated groups and entities. Furthermore, I understand that the files that I am requesting to download contain Protected Health Information ("PHI"), and that must be protected and only made available to affiliated Covered Entities for health care operational purposes consistent with 45 C.F.R. 164.501 and 506(c) and health care providers as defined by the Health Insurance Portability and Accountability Act ("HIPAA") that I/we have a treatment relationship with the patient(s).


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