Denial Letter Translation Assistance for Members
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Health Net provides no-cost translation and interpretation to all Medi-Cal members who receive denial of coverage or modification of service letters from Health Net or an affiliated participating physician group (PPG). This service is available through the Access to Interpreter Services and is offered as a supplement to translation and interpretation services provided by the member's PPG.
Health Net requests that PPGs with delegated utilization management (UM) functions attach a Health Net Language Assistance Notice (PDF) , Community Health Plan of Imperial Valley (CHPIV) Language Assistance Notice (PDF) or CalViva Health Language Assistance Notice (PDF) for denial or modification notifications sent to Health Net, CHPIV and CalViva Health Medi-Cal members. Refer to the Health Industry Collaboration Effort (HICE) website at www.iceforhealth.org/home.asp for HICE-approved Notice of Action (NOA) letter templates.
When a member calls the Health Net Medi-Cal Member Services Department , Community Health Plan of Imperial Valley Member Services Department or CalViva Health Medi-Cal Member Services Department (for Fresno, Kings and Madera counties) requesting translation or interpretation services, if Health Net did not issue the letter, a Health Net Member Services representative contacts the member's PPG and requests a copy of the denial or modification letter that was sent to the member. The PPG must submit the letter to Health Net within 48 hours in an editable format and at or below a 6th grade reading level.