21-038-send-birth-event-clinical-records-when-requested

Date: 01/15/21

This information applies to Hospitals and Ancillary providers.

For Medi-Cal, this information applies to Kern, Los Angeles, Sacramento, San Diego, San Joaquin, Stanislaus, and Tulare counties.

Additional information may be required to support the birth event

When the plan receives an inpatient notification of delivery you may receive a request from the Case Management Department to send the below information.

• Newborn’s name 
• Birth date and time   
• Birth order if multiples  
• Delivery type
• Age
• Gender
• Weight (pounds, ounces or grams)
• APGAR – 1 and 5 Minute
• Birth status:
  • Healthy/home with mom
  • Healthy/adopted or foster care
  • Sick – hospitalized
  • Detained/border baby
  • Expired

Submit clinical documentation within one business day from receipt of the request via fax at 1-855-556-7909.

Additional information

For questions about the request form, contact the Health Net Case Management Department at 1-866-801-6294, press option 2.