Health Net is committed to providing timely high-quality care, delivered by the right provider in the least restrictive treatment setting. Health Net achieves this goal through prior authorization requirements for certain treatment services.

Prior authorization provides benefits to the member by ensuring that treatments are used appropriately and serves a safeguard against treatments that may be subject to misuse or abuse. Members may also realize reduced costs by first considering alternative treatments that are as safe and effective as those proposed.

Additional value is created by considering the member within their environment and bringing those issues together to create a comprehensive treatment plan, as well as coordination of the delivery of those services. This process allows the Utilization Review Clinicians to answer the question, “where and how can this member be treated safely and most effectively in an environment that will promote optimal functioning”.