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Updates and Letters

Amendments to the information in these manuals are made through updates or signed letters distributed by fax, the United States Postal Service or other carrier and email.

18-012 – Treating and Managing Behavioral Health Conditions Primary Care Provider Toolkit is Available Online (PDF)

18-038 – Selecting Product Type Required to Check Member Eligibility on the New Provider Portal (PDF)

18-045 – Group Number is Not Required for Claims Submission and Reminder to Register for PaySpan (PDF)

18-056 – Action Requested: Invitation to Register for Upcoming Provider Webinars (PDF)

18-057 – HICN Replaced With MBI (PDF)

18-062 – After-Hours Access Guidelines and Access to Urgent/Emergent Services (PDF)

18-099 – After-Hours Acess: PCP Requirements for Urgent Services (PDF)

18-102 – Dedicated Telephone Line for Inquiries Regarding EHS Medical Group and Multicultural Medical Group Termination (PDF)

18-107 – Electronic Claims Submission Guidelines (PDF)

18-110 – 2018 PPG Webinar Calendar (PDF)

18-113 – Overdose Education and Naloxone Webinar Series (PDF)

18-122 – Medication Trend Updates and Formulary Changes – 1st Quarter 2018 (PDF)

18-131 – Medical Policies - 4th Quarter 2017 (PDF)

18-140 – Important Prior Authorization Request and Hospital Notification Contacts (PDF)

18-161 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF)

18-181 – Non-Participating Hospitals Notification for ER Admission for Post-Stabilization Services Letter (PDF)

18-183 – Health Net Implements New Payment Integrity Policies (PDF)

18-192 – New IVR Self-Service Tool for Medicare Advantage Members (PDF)

18-195 – Advance Directive Medical Record Documentation Reminder (PDF)

18-198 – Behavioral Health Documentation Standards (PDF)

18-201 –  Timely Provider Data Demographic Data Validation Reminder (PDF)

18-211 – Translated Letters Now Available on ICE Website (PDF)

18-213 – Alternative Treatments for Low Back Pain (PDF)

18-218 – Claims Receipt Date Format for Electronic and Paper Claim Forms for Individual Medicare Advantage and IFP Claims (PDF)

18-221 – Medications Newly Approved by the U.S. Food and Drug Administration (PDF)

18-268 – Quality Management Program (PDF)

18-272 – Influenza and Streptococcus Group A Testing Clinical Policy Change (PDF)

18-287 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds(PDF)

18-290 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2018 (PDF)

18-298 – Notification of Hospital Admissions (PDF)

18-305 – Q2 - Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update (PDF)

18-321 – Diabetes Prevention Program (PDF)

18-327 – Delayed Implementation of Payment Integrity Policies (PDF)

18-351 – 2018 Provider Appointment Availability & After-Hours Survey Prep (PDF)

18-356 – Partial fill schedule II drug prescriptions (PDF)

18-372 – Submitting Medical Prior Authorization Requests (PDF)

18-388 – Medical Policies - 1st Quarter 2018 (PDF)

18-353 – 2018 Provider Appointment Availability & After-Hours Survey Prep (PDF)

18-428 – Enhancement to Medicare Capitation Reports (PDF)

18-433 – Canceled Implementation of Payment Integrity Policies (PDF)

18-441 – Provider Demographic Data Validation -Q2 (PDF)

18-444 – Medical Paper Claims Submission Rejections and Resolutions (PDF)

18-447 – Secure Messaging Changes (PDF)

18-453 – State of Emergency: Health Net Members Impacted by Pawnee Fire in Lake County (PDF)

18-458 – Health Net Encourages Awareness of Opioid Potentiation Medications (PDF)

18-463 – Language Assistance Program and Cultural Competency (PDF)

18-479 – Health Net Implements New Clinical Payment Policies (PDF)

18-485 – Recovered Functionality and Improving Customer Service (PDF)

18-490 – State of Emergency: Health Net Members Impacted by West Fire in San Diego County (PDF)

18-492 – State of Emergency: Health Net Members Impacted by Holiday Fire in Santa Barbara County (PDF)

18-497 – Encounter Data Submission Deadline (PDF)

18-541 – Paper Claims Submission Address and Provider Appeals Address (PDF)

18-544 – State of Emergency: Support for Health Net Members Impacted by Cranston Fire in Riverside County (PDF)

18-552 – Promoting HN's Community Resource Center in LA (PDF)

18-558 – Updated Contract Language Required for NCQA Health Plan Accreditation (PDF)

18-564 – Submitting Claims with Member Identification Number Starting with R and AK Rejection Code (PDF)

18-572 – Accessing the Schedule of Benefits (PDF)

18-577 – Use the Correct Entity name for Paper Claims Submission (PDF)

18-578 – Silver & Fit Program Provider Flyer (PDF)

18-580 – State of Emergency: Support for Health Net Members Impacted by Holy Fire in Orange and Riverside Counties (PDF)

18-583 – Medication Trend Updates and Formulary Changes – 3rd Quarter 2018 (PDF)

18-586 – 2017 Provider Appointment Availability and After-Hours Access Survey Results (PDF)

18-591 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated - HMO/Medicare/Medi-Cal (PDF)

18-611 – Upcoming 2018 Provider Satisfaction Survey (PDF)

18-620 – Verifying Eligibility (PDF)

18-623 – Provider Offshore Subcontracting Requirements Annual Reminder (PDF)

18-657 – 2017 Progress Toward Goals for Special Needs Plan (PDF)

18-659 – Medical Policies - 1st Quarter 2018 (PDF)

18-685 – Timely Response to Request for Medical Records Reminder (PDF)

18-689 – Corrected Individual Family Plan Prior Authorization Request Form (PDF)

18-691 – Best Practices Flu Vaccine Flyer (PDF)

18-721 – Concurrent Reviews (PDF)

18-725 – Learning Collaborative to Improve HPV Immunization Rates (PDF)

18-728 – Provider Demographic Data Validation -Q3 (PDF)

18-748 – HEDIS Annual Medical Record Collection (PDF)

18-756 – How to Navigate The New Provider Portal Webinars (PDF)

18-771 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-775 – Single Member ID Now Displaying on the Provider Portal (PDF)

18-778 – Health Net Implements New Payment Integrity Policies (PDF)

18-783 – Website and Account Manager Access at provider.healthnetcalifornia.com (PDF)

18-786 – Medication Trend Updates and Formulary Changes - 4th Quarter 2018 (PDF)

18-797 – Prior Authorization Requirement Changes (PDF)

18-802 – Whooping Cough Epidemic Anticipated for 2018 (PDF)

18-824 – 2018-2019 Influence Vaccine Recommendations (PDF)

18-828 – 2019 Medicare Part D Formulary Changes (PDF)

18-844 – Reversing Opioid Depression with Naloxone Hydrochloride (PDF)

18-850 – State of Emergency: Hill and Woolsey Fires in Los Angeles and Ventura Counties (PDF)

18-851 – Q4 HCPCS DOFR Crosswalk (PDF)

18-856 – Provider Demographic Data Validation - Q4 (PDF)

18-859 – Treatment Termination Notices (PDF)

18-860 – Upcoming Deadline for Special Needs Plan Model of Care Training (PDF)

18-864 – Depression Screening and Follow-up for Adolescents and Adults (PDF)

18-874 – Medical Policies - 3rd Quarter 2018 (PDF)

18-880 – HEDIS®   Quality Measures for Patient Opioid Use (PDF)

18-884 – URGENT: Telehealth Services for California Fire Victims (PDF)

18-886 – 2019 Health Net Medicare Advantage Information (PDF)

18-895 – Medicare Encounter Data Submission Deadlines for Risk Adjustment (PDF)

18-923 – CMS Required MIPS Adjustment for Noncontracting Providers (PDF)

19-002 – Are You Ready for the CAHPS Survey? (PDF)

19-018 – Mom's Meals (PDF)

19-039 – Nonopioid Medication Options & Nonpharm Treatment (PDF) 

19-043 – Sign Up for 2019 Educational Webinars (PDF)

19-067 – Transitioning Delegated Functions (PDF)

19-074 – Inpatient Notification Requirements (PDF) 

19-087 – Use of Tamper-Resistant Controlled Substance Prescription Forms Delayed (PDF)

19-094 – Support for Providers Treating Pattients with Opiod Use Disorder (PDF)

19-110 – Expanded Criteria for Co-Prescribing Naloxone (PDF)

19-123 – Medicare Encounter Data Submission Deadlines for Risk Adjustment (PDF) 

19-125 – MIPS Payment Adjustment Data File Available Online (PDF)

19-127 – Medical Policies - 4th Quarter 2018 (PDF)

19-131 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table - Updated 1st Quarter 2019 (PDF)

19-135 – Sharing Medical Records at Health Net’s Request (PDF)

19-149 – Avoid Authorization Denials by Submitting Requested Medical Records to NIA (PDF)

19-168 – Requesting Medical Records from PPGs' Individual Practitionerr (PDF)

19-171 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer (PDF)

19-178 – State of Emergency: Counties Across California Due to Winter Storms (PDF)

19-181 – State of Emergency: 4 Additional Counties Across California Due to Winter Storms (PDF)

19-238 – AB 2193 Requires Maternal Mental Health Screening (PDF)

19-242 – Best Practices Prescribing and Managing Opioid Medications (PDF)

19-249 – CMS Provider Preclusion List and Monitoring Requirements (PDF)

19-255 – Timely Provider Demographic Data Validation Reminder (PDF)

19-303 – Nonpar Hospital ER Admission Post-stabilization Notification (PDF)

19-310 – Ultomiris™ Approved by FDA (PDF)

19-362 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 2 (PDF)

19-387 – Q2 Injectable Medication HCPCS/DOFR Crosswalk (PDF)

19-391 – Pertussis Death in California (PDF)

19-397 – Measles Outbreak Plagues California (PDF)

19-418 – Measles Outbreak Plagues California (PDF)

19-430 – Patient Education Tips for Opioid Therapy (PDF)

19-438 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2019 (PDF)

19-466 – LA County Measles Outbreak (PDF)

19-483 – Send Medical Records If Requested for Emergency Claims to Avoid Delays (PDF)

19-486 – Taper Off Opioids to Avoid Harm (PDF)

19-502 – Encounters Training for Providers (PDF)

19-525 – Medical Policies - 1st Quarter 2018 (PDF)

19-533 – Advanced Access Flyer (PDF)

19-537 – Timely Provider Demographic Data Validation Reminder (PDF)

19-556 – Improve Your Access and Availabiltiy Provider Online Trainging Flyer (PDF)

19-561 – Language Assistance Program and Cultural Competency Services (PDF)

19-576 – Labcorp- Walgreen Draw Sites (PDF)

19-582 – Use Apria for Covered DME and Home Respiratory Services (PDF)

19-651 – Reduce the Number of Heart Attacks and Strokes (PDF)

19-666 – Prior Authorization Requirement Changes (PDF)

19-696 – Medi-Cal 2018 Provider Appointment Availability and After-Hours Access Survey Results (PDF)

19-701 – Medication Trend Updates and Formulary Changes – 3rd Quarter 209 (PDF)

19-725 – Timely Provider Demographic Data Validation Reminder Q3 (PDF)

19-734 – Help Patients Better Control their Asthma and its Triggers (PDF)

19-738 – Feedback Needed – 2019 Provider Satisfaction Survey (PDF)

19-754 – Prepare for the 2019 Provider Appointment Availability and After-Hours Access Survey (PDF)

19-794 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update – 3rd Quarter 2019 (PDF)

19-806 – November Provider Online Training (PDF)

19-810 – December Provider Online Training (PDF)

19-820 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 4 (PDF)

19-824 – Prior Authorization Requirement Changes (PDF)

19-829 – Reconcile Your Payments Quicker (PDF)

19-832 – State of Emergency: Fires in Los Angeles and Riverside Counties (PDF)

19-834 – Medical Policies - 2nd Quarter 2018 (PDF)

19-838 – HEDIS Annual Medical Record Collection (PDF)

19-845 – Submit Professional Anesthesia Encounters with MJ Qualifier (PDF)

19-869 – State of Emergency: Fires in Los Angeles and Sonoma Counties (PDF)

19-871 – State of Emergency Declared throughout the State of California (PDF)

19-879 – Get Ready for the Great American Smokeout on November 21, 2019 (PDF)

19-907 – Bill Telehealth Services Correctly to Receive Timely Payment (PDF)

19-916 – Medication Trend Updates and Formulary Changes - 4th Quarter 2019 (PDF)

19-921 – 2020 Individual Medicare Advantage Plan Information (PDF)

19-923 – Medical Policies 3rd Qtr 2019 (PDF)

19-927 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update -4th Quarter 2019 (PDF)   

19-933 – Submit additional Claims Info to PPG When PPG is Financially Responsible (PDF) 

19-949 – Your working to treat opioid misuse. Let us help. (PDF)

19-966 – Include Your Correct NPI on Capitated Encounter Submissions to Avoid Claim Delays (PDF)

19-968 – Submit Encounter Data for 2018 Dates of service by December 27, 2019 (PDF)

19-969 – Update Your Demographic Information (PDF

19-992 – Refer your Health Net Patients to Adventist Health Tulare (PDF)

    UPDATES AND LETTERS FOR 2020 AND BEYOND

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    Last Updated: 05/20/2021