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Updates and Letters

Amendments to the information in this manual are made through updates or signed letters distributed by fax, the United States Postal Service or other carrier and email.

18-005 – Physician Certification Statement for Non-Emergency Medical Transportation for Cal MediConnect Enrollees (Shared Risk) (PDF)

18-008 – NEMT/NMT Benefit Change Dual Risk (PDF)

18-011 – NEMT/NMT Benefit Change Shared Risk (PDF)

18-013 – Treating and Managing Behavioral Health Conditions Primary Care Provider Toolkit is Available Online (PDF)

18-063 – After-Hours Access Guidelines and Access to Urgent/Emergent Services (PDF)

18-080 – Time Frames to Reply to Request for Records for Independent Medical Reviews (PDF)

18-100  – After-Hours Acess: PCP Requirements for Urgent Services (PDF)

18-104 – Dedicated Telephone Line for Inquiries Regarding EHS Medical Group and Multicultural Medical Group Termination (PDF)

18-111 – 2018 PPG Webinar Calendar (PDF)

18-114 – Overdose Education and Naloxone Webinar Series (PDF)

18-132 – Medical Policies - 4th Quarter 2017 (PDF)

18-163 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF)

18-185 – Health Net Implements New Payment Integrity Policies (PDF)

18-196 – Advance Directive Medical Record Documentation Reminder (PDF)

18-202 –  Timely Provider Data Demographic Data Validation Reminder (PDF)

18-212 – Translated Letters Now Available on ICE Website (PDF)

18-215 – Alternative Treatments for Low Back Pain (PDF)

18-220 – DHCS Medical Review Audit Notification (PDF)

18-222 – Medications Newly Approved by the U.S. Food and Drug Administration (PDF)

18-261 – Quality Management Program (PDF)

18-271 – Influenza and Streptococcus Group A Testing Clinical Policy Change (PDF)

18-289 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-299 – Notification of Hospital Admissions (PDF) 

18-302 – DHCS Medi-Cal Documenting and Reporting Immunization Requirements (PDF)

18-306 – Q2 - Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update (PDF)

18-312 – Correction - 18-212, Health Net Translated Letter Templates Available on ICE Website (PDF)

18-322 – Diabetes Prevention Program (PDF)

18-329 – Delayed Implementation of Payment Integrity Policies (PDF)

18-352 – 2018 Provider Appointment Availability & After-Hours Survey Prep (PDF)

18-386 – Expanded List of Providers Who Can Authorize Non-Emergency Medical Transportation (NEMT) for Cal MediConnect Enrollees (Shared Risk PPGs) (PDF)

18-389 – Medical Policies - 1st Quarter 2018 (PDF)

18-426 – Indian Health Services (PDF)

18-427 – Indian Health Services - IHS Providers (PDF)

18-435 – Canceled Implementation of Payment Integrity Policies (PDF)

18-440 – 2018 New Provider Packet Cal MediConnect Operation Guide (PDF)

18-442 – Provider Demographic Data Validation -Q2 (PDF)

18-446 – Medical Paper Claims Submission Rejections and Resolutions (PDF)

18-448 – Secure Messaging Changes (PDF)

18-459 – Health Net Encourages Awareness of Opioid Potentiation Medications (PDF)

18-481 – Health Net Implements New Clinical Payment Policies (PDF)

18-491 – State of Emergency: Health Net Members Impacted by West Fire in San Diego County (PDF)

18-498 – Encounter Data Submission Deadline (PDF)

18-519 – Staying Healthy Assessment Update (PDF)

18-553 – Promoting HN's Community Resource Center in LA (PDF)

18-559 – Updated Contract Language Required for NCQA Health Plan Accreditation (PDF)

18-565 – Submitting Claims with Member Identification Number Starting with R and AK Rejection Code (PDF)

18-590 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF)

18-612 – Upcoming 2018 Provider Satisfaction Survey (PDF)

18-624 – Provider Offshore Subcontracting Requirements Annual Reminder PDF)

18-629 – 2018 Health Net Cal MediConnect Operations Guide Online (PDF)

18-640 – Cal MediConnect Translated Letters on ICE Website (PDF)

18-660 – Medical Policies - 2nd Quarter 2018 (PDF)

18-686 – Timely Response to Request for Medical Records Reminder (PDF)

18-692 – Best Practices Flu Vaccine Flyey (PDF)

18-722 – Concurrent Reviews (PDF)

18-729 – Provider Demographic Data Validation -Q3 (PDF)

18-749 – HEDIS Annual Medical Record Collection (PDF)

18-752 – Independent Medical Review (IMR) (PDF)

18-773 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-780 – Health Net Implements New Payment Integrity Policies (PDF)

18-798 – Prior Authorization Requirement Changes (PDF)

18-804 – Whooping Cough Epidemic Anticipated for 2018 (PDF)

18-826 – 2018-2019 Influence Vaccine Recommendation (PDF)

18-847 – Reversing Opioid Depression with Naloxone Hydrochloride (PDF)

18-852 – Q4 HCPCS DOFR Crosswalk (PDF)

18-857 – Provider Demographic Data Validation - Q4 (PDF)

18-863 – Update to Provider Update 17-268 - Clinical Depression and Follow-up Plan (CDF) Screening for Medi-Cal (PDF)

18-873 – Medical Policies - 3rd Quarter 2018 (PDF)

18-882 – HEDIS®   Quality Measures for Patient Opioid Use (PDF)

18-887 – 2019 Health Net Cal MediConnect Plans (PDF)

18-896 – Medicare Encounter Data Submission Deadlines for Risk Adjustment (PDF)

18-924 – CMS Required MIPS Adjustment for Noncontracting Providers (PDF)

18-929 – Claims Rejection Letters to Be Sent Beginning December 26, 2018 (PDF)

 

19-004 – Are You Ready for the CAHPS Survey? (PDF)

19-019 – Mom's Meals (PDF)

19-025 – Alcohol Misuse: Screening and Behavioral Counseling Interventions (PDF)

19-038 – Results from Review of Medical Record Documentation (PDF)

19-041 – Nonopioid Medication Options & Nonpharm Treatment (PDF)

19-045 – Sign Up for 2019 Educational Webinars (PDF)

19-069 – Transitioning Delegated Functions (PDF)

19-076 – Inpatient Notification Requirements (PDF)

19-088 – Use of Tamper-Resistant Controlled Substance Prescription Forms Delayed (PDF)

19-095 – Support for Providers Treating Pattients with Opiod Use Disorder (PDF)

19-099 – Updates to Family Planning (PDF)

19-111 – Expanded Criteria for Co-Prescribing Naloxone (PDF)

19-124 – Medicare Encounter Data Submission Deadlines for Risk Adjustment (PDF)

19-126 – MIPS Payment Adjustment Data File Available Online (PDF)

19-128 – Medical Policies - 4th Quarter 2018 (PDF)

19-132 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table - Updated 1st Quarter 2019 (PDF)

19-137 – Sharing Medical Records at Health Net’s Request (PDF)

19-160 – Have Your Patients Completed Their Health Risk Assessment? (PDF)

19-166 – Requesting Medical Records from PPGs' Individual Practitioners (PDF)

19-173 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer (PDF)

19-179 – State of Emergency: Counties Across California Due to Winter Storms (PDF)

19-240 – AB 2193 Requires Maternal Mental Health Screening (PDF)

19-244 – Best Practices Prescribing and Managing Opioid Medications (PDF)

19-250 – CMS Provider Preclusion List and Monitoring Requirements (PDF)

19-257 – Timely Provider Demographic Data Validation Reminder (PDF)

19-260 – CBAS Update and Ops Manual Changes (PDF)  

19-311 – Ultomiris™ Approved by FDA (PDF)

19-350 – Cal MediConnect 2019 Operations Guide (PDF)

19-357 – CMC Provider Library Brochure - Health Net's Provider Library (PDF)

19-358 – CMC Provider Portal Brochure - Unlock the Advantages of HealthNet.com (PDF)

19-364 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 2 (PDF)

19-389 – Q2 Injectable Medication HCPCS/DOFR Crosswalk (PDF)

19-392 – Pertussis Death in California (PDF)

19-396 – Measles Outbreak Plagues California (PDF)

19-420 – Measles Outbreak Plagues California (PDF)

19-432 – Patient Education Tips for Opioid Therapy (PDF)

19-467 – LA County Measles Outbreak (PDF)

19-484 – Send Medical Records If Requested for Emergency Claims to Avoid Delays (PDF)

19-488 – Taper Off Opioids to Avoid Harm (PDF)

19-504 – Encounters Training for Providers (PDF)

19-522 – Achieve Better Heatlh Outcomes for Your Patients (PDF)

19-526 – Medical Policies - 1st Quarter 2018 (PDF)

19-532 – CBAS Treatment Request Forms (PDF)

19-535 – Advanced Access Flyer (PDF)

19-539 – Timely Provider Demographic Data Validation Reminder (PDF)

19-560 – Language Assistance Program and Cultural Competency Services (PDF)

19-569 – Get ready for the CAHPS survey (PDF)

19-573 – Pain Management and Opioids CME flyer (PDF)

19-575 – Care Plan Option Services Update - RESPITE CARE PROGRAM (PDF)

19-577 – Labcorp- Walgreen Draw Sites (PDF)

19-583 – Use Apria for Covered DME and Home Respiratory Services (PDF)

19-590 – ADA Diabetes and Overcoming Therapeutic Workshop (PDF)

19-607 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 3 (PDF)

19-627 – Improve Quality of Care and Reduce Readmissions through Safe Hospital Discharge (PDF)

19-644 – Refer Patients to myStrength.com for Pregnancy and Early Parenting Support (PDF)

19-653 – Reduce the Number of Heart Attacks and Strokes (PDF)

19-663 – COL Tip Sheet (PDF)

19-667 – Prior Authorization Requirement Changes (PDF)

19-677 – Check Out the Cal MediConnect 2019 Operations Guide Online (PDF)

19-727 – Timely Provider Demographic Data Validation Reminder Q3 (PDF)

19-736 – Help Patients Better Control their Asthma and its Triggers (PDF)

19-740 – Feedback Needed – 2019 Provider Satisfaction Survey (PDF)

19-747 – Diabetes Workshop Extended Deadline (PDF)

19-756 – Get Ready for the 2019 Provider Appointment Availability and After-Hours Access Surveys (PDF)

19-790 – Avoid Claims Issues by Knowing Which Services Will Not Be Covered as of January 1, 2022 (PDF)

19-795 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update – 3rd Quarter 2019 (PDF)

19-807 – November Provider Online Training (PDF)

19-811 – December Provider Online Training (PDF)

19-817 – Improve Treatment of OUD in Pregnancy with these Resources (PDF)

19-822 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 4 (PDF)

19-826 – Prior Authorization Requirement Changes (PDF) 

19-830 – Reconcile Your Payments Quicker (PDF)

19-833 – State of Emergency: Fires in Los Angeles and Riverside Counties (PDF)

19-835 – Medical Policies - 2nd Quarter 2018 (PDF)

19-840 – HEDIS Annual Medical Record Collection (PDF)

19-847 – Submit Professional Anesthesia Encounters with MJ Qualifier (PDF)

19-853 – Changes to Member Appeals Process (PDF)

19-870 – State of Emergency: Fires in Los Angeles and Sonoma Counties (PDF)

19-873 – State of Emergency Declared throughout the State of California (PDF)

19-881 – Get Ready for the Great American Smokeout on November 21, 2019 (PDF)

19-899 – Bill Claims for CAR T-cell Therapy to Medicare to get Paid (PDF) 

19-907 – Bill Telehealth Services Correctly to Receive Timely Payment (PDF)

19-919 – New Requirements for Individual Care Plan per Three-Way Contract (PDF)  

19-922 – 2020 Cal MediConnect Plan Codes and Supplemental Benefits (PDF)

19-924 – Medical Policies 3rd Qtr 2019 (PDF) 

19-928 –  Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update -4th Quarter 2019 (PDF) 

19-935 – Submit additional Claims Info to PPG When PPG is Financially Responsible (PDF) 

19-951 – Your working to treat opioid misuse. Let us help. (PDF)  

19-965 – Include Your Correct NPI on Capitated Encounter Submissions to Avoid Claim Delays (PDF) 

19-967 – Submit Encounter Data for 2018 Dates of service by December 27, 2019 (PDF)  

19-971 – Update Your Demographic Information (PDF)  

19-1004 – Continuity of Care for Maternal Mental Health Conditions (PDF) 

    UPDATES AND LETTERS FOR 2020 AND BEYOND

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    Last Updated: 05/20/2021