21-212 Post-Stabilization Authorization for Emergency Out-of-Network (OON) Hospital Services Suspended
Date: 03/08/21
This information applies to Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Participating physician groups (PPGs) must continue to refer authorization requests for post-stabilization services to Health Net
Due to the COVID-19 pandemic, on March 18, 2020, Health Net paused all OON hospital post-stabilization authorization reviews until further notice. Health Net is responsible for managing these reviews. PPGs should not be reviewing OON hospital post-stabilization authorization requests. PPGs are to refer these back to Health Net for adjudication.
Go to the online COVID-19 alerts page for info about COVID-19 vaccines!
At the online COVID-19 alerts page, you will find information about COVID-19 vaccines. This includes COVID-19 vaccine coverage details, how to enroll to administer the COVID-19 vaccine, and COVID-19 vaccine reporting and coding requirements. Also, access key tips you can use to help talk with and answer questions from your patients about the COVID-19 vaccine, especially those who are hesitant to receive it.
Additional information
If you have questions regarding the information contained in this update, contact the applicable Health Net Provider Services Center within 60 days at:
Line of Business | Telephone Number | Provider Portal | Email Address |
|---|---|---|---|
EnhancedCare PPO (IFP) | 1-844-463-8188 | ||
EnhancedCare PPO (SBG) | 1-844-463-8188 | provider_services@healthnet.com | |
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 1-800-641-7761 | provider_services@healthnet.com | |
IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO) | 1-888-926-2164 | provider_services@healthnet.com | |
Medicare (individual) | 1-800-929-9224 | provider_services@healthnet.com | |
Medicare (employer group) | 1-800-929-9224 | provider_services@healthnet.com | |
Medi-Cal | 1-800-675-6110 | N/A |