Health Net Provider Services Center
The Health Net Provider Services Center is available to physicians, participating physician groups (PPGs), hospitals, and other providers, and features live customer service representatives, an interactive voice response (IVR) system and the provider portal websites. Customer service representatives are available via telephone and online during business hours (Monday through Friday, 8:00 a.m. to 6:00 p.m.). Services provided include the following:
- Member eligibility and effective dates information.
- Health Net's prescription drug program information.
- Claims status information.
- Instructions on how to submit disputes and appeals.
- Instructions on how to submit a complaint regarding the provision of care by a provider or express concerns about provider office staff.
- Instructions on how to request the removal of members for disciplinary actions.
- Information about the provider portal websites.
IVR for Employer Group EPO, HMO, HSP, and PPO members
The Health Net Provider Services Center IVR system is a quick and accurate way to verify member eligibility and claim information without waiting to speak with a Provider Services Center representative. For employer group EPO, HMO, HSP and PPO members, providers may contact 1-800-641-7761. The IVR includes:
- Current and past eligibility status.
- Benefits information.
- Single or multiple claims status.
- Claims submission addresses.
- Automated fax back of member eligibility and claim status information.
IVR for Covered California and Individual Family Plan (IFP) members
The Health Net Provider Services Center IVR system is a quick and accurate way to verify member The following IVRs are available for Covered California and IFP members, which include CommunityCare HMO, PureCare HSP, Pure Care EPO and PPO Individual and Family members (EnhancedCare PPO members are excluded). Providers may verify or check eligibility status by member name and plan, claims status and copayment information.
|If...||Then contact Health Net at...||And...|
|Covered California appears on the member identification (ID) card||1-888-926-2164 for Covered California Health Net members||Follow the prompts|
|Covered California does not appear on the member (ID) card||1-877-857-0701 for Health Net IFP members||Follow the prompts|
|Line of Business||Telephone Number||Provider Portal Website|
Health Net Commercial Claims
PO Box 9040
Farmington, MO 63640-9040