20-717 Entering Other Insurance Carrier Payment Information for Online Claims

Date: 09/16/20

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

Ensure your claims process accurately and timely

Be sure to enter corresponding claims data online before submitting claims with explanation of benefits (EOB) attachments. This is needed to capture claims information correctly.

Follow the simple steps shown below.

1      Log in to the provider portal at provider.healthnetcalifornia.com. Select product type (use the drop-down menu on top of the screen to choose Health Net Commercial – CA for IFP members), then select Go.

2      Select the Claims tab.

3      Enter Primary Insurance information.

• For CMS-1500, enter diagnosis information, then select Carrier Type from the drop down and enter Policy Number under the Primary Insurance section.

On the next screen after entering the procedure and billing information, enter the EOB information.

• For a UB-04, after entering the service line information, add all EOB information under the Primary Insurance section.

4      Attach an electronic copy of the EOB to the claim prior to submission. Select Primary Carrier EOB from the drop down and upload the document. This step is for both CMS-1500 and UB-04.

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email at provider_services@healthnet.com within 60 days, by telephone or through the Health Net provider website as listed in the right-hand column on page one.