21-125 State of Emergency: Winter Storms in Monterey and San Luis Obispo Counties
Date: 02/02/21
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.
Support for Health Net members impacted by the Winter Storms
On January 29, 2021, Governor Gavin Newsom declared a state of emergency in Monterey and San Luis Obispo counties due to the severe winter storms that brought damaging winds and have caused flooding, mudslides, erosion, damage to critical infrastructure, including washing out a portion of Highway 1. Health Net is providing assistance to members in Monterey and San Luis Obispo counties affected by such winter storms.
We want to help ensure that members who have been impacted because they or their usual health care providers have been temporarily displaced, have continued access to health care services and prescriptions during the state of emergency.
Here is what you need to know.
Prior authorization, precertification and referrals
Health Net is taking steps to ensure that Health Net participating providers in areas affected by the winter storms are able to continue providing care for Health Net members’ medical needs.
Health Net participating providers may call the Provider Services Center using the contact information provided in the right-hand column of this page for guidance on:
- Easing of time limitations for prior authorizations, precertification and referrals for treatment.
- Approval for out-of-network services in the event a contracting provider or facility becomes unavailable.
- Authorization for the replacement of medical equipment or supplies.
Filing claims
The deadline to file claims for providers impacted by the winter storms will be extended. Providers may contact the Provider Services Center using the contact information provided below for additional guidance on claims extension time frames.
Prescription information
Health Net will approve any essential prescription medications (with current copayments and deductibles) for any Health Net member in Monterey and San Luis Obispo counties whose medication was lost or remained behind during an evacuation. Providers should inform their Health Net patients that to obtain an emergency supply, affected members can return to the pharmacy where the original prescription was filled. If the pharmacy is not open due to the state of emergency, affected Health Net members can contact Health Net’s Emergency Response line at 1-800-400-8987, 8 a.m. to 6 p.m. Pacific time (PT), for questions or assistance.
Coping assistance
Health Net members who lost their homes or have been evacuated due to the winter storms may contact MHN, Health Net’s behavioral health subsidiary, for referrals to mental health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss, or other trauma resulting from the winter storms. For the duration of the state of emergency and its immediate aftermath, affected Health Net members may contact MHN 24 hours a day, seven days a week at 1-800-227-1060.
Additional information
Depending on how the winter storms progress, Health Net may make additional changes to its policies as needed to ensure members have access to necessary health care services.
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email or by phone at 1-800-641-7761.
Line of Business | Telephone Number | Provider Portal | Email Address |
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EnhancedCare PPO (IFP) | 1-844-463-8188 |
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EnhancedCare PPO (SBG) | 1-844-463-8188 |
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Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 1-800-641-7761 |
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IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO) | 1-888-926-2164 |
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