Health Net Program Accreditation Department
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The Health Net Program Accreditation Department supports and promotes activities to assess and monitor organization-wide and provider compliance with regulatory and oversight bodies, including the California Department of Managed Health Care (DMHC), the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services (CMS), the Department of Health Care Services (DHCS), and the California Managed Risk Medical Insurance Board (MRMIB). The department is also responsible for preparation and implementation of any identified actions based on the findings of DMHC, NCQA and CMS audits.
The Program Accreditation Department collects, reviews and assesses various required submissions from delegated participating physician groups (PPGs), including financial statements and utilization management reports.
Address to submit expedited organization determination (EOD), Notice of Medicare Non-Coverage (NOMNC) tracking logs, utilization management and financial reports:
Program Accreditation Department Compliance Analyst
Provider Oversight efax: 877-890-4105