Health Net Medi-Cal Provider Services Department
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As a State Health Program, Health Net has some unique characteristics that make timely response and accurate information necessary. If prompt and accurate information is not provided, a member may misuse the program, resulting in medical services not being covered. To avoid this, Health Net directs inquiries from providers to Health Net's Medi-Cal Provider Services Department or to Health Net's Provider Engagement Network Specialists, where available. Members are directed to the Medi-Cal Member Services Department.
Health Net's Medi-Cal Provider Services Department Customer Service Advocates are available 24 hours a day, seven days a week, to assist providers with:
- Member eligibility, effective dates and eligibility research
- Primary care physician (PCP) selection and transfer requests for members
- Questions about the Plan’s Medi-Cal Rx Contract Drug List (CDL)
- Benefit information
- Professional and hospital billing
- Claims
- Questions regarding claims status
- Exceptions and administrative decisions
- Complaints and grievances regarding provider care, delivery of care or participating physician group (PPG) staff
- Requests for removal/PCP/PPG reassignment for non-compliant members
The Health Net Medi-Cal Provider Services Department toll-free telephone number is printed on the back of the member's identification card. The servicing provider is responsible for confirming the member(s) eligibility at the time of service.
Health Net Provider Services Department Phone Number: 800-675-6110, option 2
Providers may use HNMedi-cal.ClaimsInquiry@healthnet.com for claim status only if the provider portal is down or not working. This email is only for claim status and denial inquiries.
To disenroll a non-compliant member refer to Disenrollment section.
Fax or mail the formal letter and all supporting document’s to:
Attn: Non-Compliance Unit
Fax: (844) 837-5947
Address: PO BOX 10303, Van Nuys, CA 91410-0303