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21-412 See What News is Online for May 2021

Date: 06/07/21

View the latest info that can help you do business with us

 

Date posted

Number and title

Type of notice

Audience

Lines of business

May 10, 2021

21-336m, Prior Authorization Reminder for Outpatient Therapy Visits

News & Announcements

  • Physicians
  • HMO/POS/HSP
  • PPO
  • EPO
  • Medicare Advantage
  • Medi-Cal (all counties)
  • Molina

Summary:  As a reminder, prior authorization is required after 12 combined outpatient therapy visits. Outpatient therapies/rehabilitation services include physical, occupational and speech therapy. Visits 1-12 do not require authorization.

 

Date posted

Number and title

Type of notice

Audience

Lines of business

May 24, 2021

21-377m, We Want to Hear From You - 2021 Provider Satisfaction Survey

News & Announcements

  • Physicians
  • PPGs
  • HMO/POS/HSP
  • PPO
  • EPO
  • Medicare Advantage
  • Medi-Cal (all counties)

Summary: Starting in June 2021, randomly selected providers will receive the annual Provider Satisfaction Survey. The survey is conducted by SPH Analytics, an independent research firm. Please share your feedback to help us better serve you.

 

Date posted

Number and title

Type of notice

Audience

Lines of business

May 24, 2021

21-318m, Medi-Cal Member Reward Cards Program. Improve Your HEDIS® Scores and Help Members Earn Rewards

Flyer

  • Physicians
  • PPGs
  • Hospitals
  • Ancillary providers
  • Medi-Cal (Kern, Los Angeles, Sacramento, San Diego, San Joaquin, Stanislaus and Tulare counties)

Summary: Health Net members who have yet to complete their 2021 health care activities outlined in the flyer will receive an offer to get a reward for completing a service. Members must complete and attest to the health care activities by December 31, 2021.

 

Date posted

Number and title

Type of notice

Audience

Lines of business

May 28, 2021

21-383m, Reminder: Send Required Special Needs Discharge Data to Health Net

Flyer

  • Hospitals
  • Ancillary providers
  • Medicare Advantage

Summary: Effective March 1, 2021, the Department of Health Care Services (DHCS) requires dual-eligible special needs plans to provide admissions, discharge and transfer (ADT) data to the DHCS. Prior to that date, hospitals and skilled nursing facilities (SNFs) primarily sent ADT data only to participating provider groups. Refer to this provider update for a reminder that hospitals and SNFs must now also send ADT data for special needs members to Health Net.

 

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

provider.healthnetcalifornia.com

provider_services@healthnet.com

EnhancedCare PPO (SBG)

1-844-463-8188

provider.healthnet.com

provider_services@healthnet.com

Health Net Employer Group HMO, POS, HSP, PPO, & EPO

1-800-641-7761

provider.healthnet.com

provider_services@healthnet.com

IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO)

1-888-926-2164

provider.healthnetcalifornia.com

provider_services@healthnet.com

Medicare (individual)

1-800-929-9224

provider.healthnetcalifornia.com

provider_services@healthnet.com

Medicare (employer group)

1-800-929-9224

provider.healthnet.com

provider_services@healthnet.com

Medi-Cal

1-800-675-6110

provider.healthnet.com

N/A


Last Updated: 06/04/2021