Denial Letter Translation Assistance for Members
- Participating Physician Groups (PPG)
- Los Angeles
- San Diego
- San Joaquin
Health Net provides translation services 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 Language Assistance Notice (PDF), or CalViva Health Language Assistance Notice (PDF). for denial or modification notifications sent to Health Net Medi-Cal members. Refer to the Industry Collaboration Effort (ICE) website at www.iceforhealth.org/home.asp for ICE-approved Notice of Action (NOA) letter templates.
When a member calls the Health Net Medi-Cal Member Services Department or CalViva Health Medi-Cal Member Services Department (for Fresno, Kings and Madera counties) requesting translation 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 one business day.