Coordination of Care

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

The primary care physician (PCP) is responsible for supervision of physician extenders, providing ongoing care and coordination of all services the member receives. The provider must verify any suspected serious medical condition (for example, heart murmur, scoliosis and developmental problems). If needed services fall outside the PCP's scope of practice, referrals must be made and treatment initiated within 60 days after the health assessment appointment at which the condition was identified. The Health Net Medi-Cal Health Services Department is available to provide coordination, if indicated by the member's condition and requested by the PCP.

Physician extenders may not be barriers to a request to see a physician. Any member being cared for by a physician extender must be given an appointment with the PCP without having to work through the physician extender.

Health Net's public programs administrators specialists receive information from the Health Net Medi-Cal Member Services Department regarding members who have disenrolled. The Health Net public programs specialist informs the local Child Health and Disability Prevention (CHDP) program office of the mandatory disenrollment of members under age 21 and assists in transition of care as necessary.

If members in need of transportation assistance do not meet the criteria for non-emergency transportation, the PCP refers the member to the CHDP program office.