20-293 Update Your Demographic Information

Date: 03/24/20

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.

This information applies to Medi-Cal in Fresno, Kings and Madera counties.

AVOID BEING REMOVED FROM THE PROVIDER DIRECTORIES

Keep your office information current! This lets CalViva Health members reach you to schedule appointments or select you as their provider. Be sure to validate your demographic information each month so it’s correct in the ProviderSearch tool at provider.healthnet.com.

Go online or call to change your office information

Online

Complete the online form on the Health Net provider website at provider.healthnet.com under My Account > Profile > Update Provider Information. You must have Update Provider Information privileges to update and submit changes online.

Call

Reach out to your provider network administrator (PNA).

Required time frames

30 days prior

Any changes to your demographic information.

5 days prior

Change to your status of accepting new patients. You can notify Health Net*, CalViva Health or the participating physician group (PPG).

Providers contracting through a PPG must notify the PPG directly of changes, and the PPG notifies Health Net.

Reply to calls and letters

You may receive an email, fax or telephone call once or more each year asking you to validate your demographics. You must respond to avoid being removed, in most cases, from the Health Net provider directory.

CalViva Health, Health Net or a regulator may contact you

Please respond timely to requests from Health Net or a regulator about the status of your contract and demographic information. Be sure to have an administrator or member of your team who is familiar with your contract details respond to these requests.

PPG requirements

PPGs must have policies in place that establish and implement processes to collect, maintain and submit their provider demographic changes to Health Net, on behalf of CalViva Health, on a real-time basis. Real time is within 30 days, as defined by the Centers for Medicare & Medicaid Services (CMS). Health Net conducts random audits of PPGs to validate processes and policies to ensure they are maintaining provider demographic information on a regular basis.

Questions?

Please contact CalViva Health at 1-888-893-1569 with any questions about the information in this flyer.