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Claims Submission

Provider Type

  • Participating Physician Groups (PPG)
  • Ancillary

The following is applicable to shared-risk participating physician groups (PPGs) or when Health Net is at risk. Claims for durable medical equipment (DME) must include the following information:

  • A copy of the bill for each item attached to the completed claim form
  • "EQUIP" written in the procedure column
  • Name of the equipment written in the description column (more than one line may be used)
  • Reference to the authorization number, when indicated
Last Updated: 07/01/2024