Continuity of Care
- Physicians (does not apply to CMC)
- Participating Physician Groups (PPG)
Members who meet the following criteria may be eligible for continuity of care (COC) when they currently are undergoing care with a non-contracted provider and:
- The provider contract is terminated for a reason other than medical discipline, fraud or crime.
- Member had a participating physician group (PPG) change due to provider contract termination or provider leaving assigned PPG.
- Are new members.
Refer to the Health Net Member Services Department for assistance.
COC services not covered for Medicare members are:
- Durable medical equipment (DME) providers or other ancillary services, such as transportation or carve-out services.
- Out-of-network providers who do not agree to abide by Health Net's utilization management policies.