Claims and Provider Reimbursement
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
This section describes claims and provider reimbursement
Select any subject below:
- Remittance Advice and Explanation of Payment System
- Accessing Claims on Health Net Provider Portal
- Adjustments
- Balance Billing
- Billing and Submission
- Capitated Claims and Billing Information
- Eligibility and Capitation
- Eligibility Guarantee
- Telehealth Billing Requirement
- Emergency Claims Processing
- Fee-For-Service Billing and Submission
- Insured Services
- Premium Payment Grace Period for Beneficiary Qualifying for APTC
- Professional Claim Editing
- Professional Stop Loss
- Refunds
- Reimbursement
- Reinsurance
- Schedule of Benefits or Summary of Benefits
- Shared Risk
- Timely Filing Criteria
- When Medicare is a Secondary Payer