Inquiry Submission

For routine claim follow-up, providers may use the State Health Programs (SHP) Provider Inquiry Spreadsheet (PDF). Use this spreadsheet for resubmission of contested claims with missing information (requested individual claim documents), submission of a corrected billing (additional charges previously not submitted), inquiries regarding claim status and payment calculation clarification, and assistance in determining member responsibility.
Providers may use their own spreadsheet or form but must include the following information to ensure appropriate research:

• Member's name
• Member's date of birth (DOB)
• Health Net identification (ID) number
• Date of service
• Billed amount
• Claim number

Submit provider inquiry requests to the Health Net Medi-Cal Provider Services Center, Community Health Plan of Imperial Valley Provider Services Center or CalViva Health Provider Services Center.

Providers who participate in Health Net's Medi-Cal plan under a capitated agreement with a participating physician group (PPG) must submit inquiries to the PPG or affiliated health plan (Molina Healthcare in Los Angeles County) that processed the claim.