21-662m Required Medi-Cal Training and Attestation Form

Date: 09/23/21

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

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

Newly contracting Medi-Cal providers must complete training, sign and return the training attestation form

As a reminder, providers who are newly contracting for Medi-Cal must take the below actions:

1. Complete required provider training. Access educational training materials and the training attestation form online. Go to Health Net’s provider website, under Resources for you, select > New Provider Medi-Cal Welcome Packet.
2. Sign and return the training attestation form. The newly contracting Medi-Cal provider who completed the trainings must sign the form to be active in Health Net’s system. Staff members cannot sign the form on behalf of a provider, and providers cannot waive required trainings. The training attestation form is a required part of the provider contracting and credentialing process. A copy of the training attestation form is attached for reference.

Participating physician groups (PPGs) delegated to perform credentialing on behalf of Health Net must make sure newly contracting Medi-Cal providers complete the steps above.

In-person or virtual training

Provider Relations is available to train you and your staff in person or virtually. Please email your training request to HealthNet Provider Relations. Include your complete name, address and a contact number in the email.

Who are newly contracted providers?

Newly contracting providers are:

1. Providers who wish to be contracted with Health Net and are ready to fulfill all credentialing and contracting requirements to be entered into Health Net’s contract systems with an active status date.
2. Providers who have ended their relationship with Health Net at least 30 calendar days prior to establishing a new contractual relationship and new active status date.

Medi-Cal providers who are changing or adding PPG affiliations or who are making demographic or specialty changes are not considered newly contracting providers.

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Medi-Cal Provider Services Center within 60 days at 800-675-6110.