Claims and Provider Reimbursement
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
This section describes claims and provider reimbursement
Select any subject below:
- Remittance Advice and Explanation of Payment System
- Accessing Claims on the Health Net Provider Portal
- Adjustments
- Balance Billing
- Billing and Submission
- Capitated Claims Billing Information
- Claims Processing for DSNP in EAE Counties
- Eligibility and Capitation
- Eligibility Guarantee
- Fee-For-Service Billing and Submission
- Telehealth Billing Requirement
- Institutionalized Members
- Medicare Risk Adjustment Report
- Payment for Service of Non-Participating Providers
- Professional Claim Editing
- Professional Stop Loss
- Provider Participation Agreement
- Refunds
- Reimbursement
- Reinsurance
- Schedule of Benefits and Summary of Benefits
- Shared Risk
- When Medicare is a Secondary Payer