21-735 Send a List of Your GEMT Providers to Help with Automated Payments
Date: 10/25/21
This information applies to Participating Physician Groups (PPGs) and Hospitals.
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
New annual requirement starts January 1, 2022
Participating physician groups (PPGs) and hospitals must submit a list of their contracted ground emergency medical transportation (GEMT) providers each year. This applies to Medi-Cal providers contracted with Health Net under a global and dual risk arrangement.
The list will help identify non-contracted GEMT providers for automated payments that meet the requirements under the quality assurance fee (QAF) program.1
Due date
Your list is due no later than March 31 of each year starting in 2022.
Include this information
At a minimum, you must have the following information on the list you submit each year.
- Provider name.
- Provider type (PPG or Hospital).
- Risk type (Dual or Global).
- GEMT provider name.
- GEMT National Provider Identifier (NPI) number.
Where to send your list
You can send it directly to your assigned Provider Relations & Contracting Specialist (PRCS).
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 | |
| Cal Mediconnect – Los Angeles County | 1-855-464-3571 | N/A | provider_services@healthnet.com |
| Cal Mediconnect – San Diego County | 1-855-464-3572 | N/A | provider_services@healthnet.com |
1 The Department of Health Care Services established the QAF program. Visit the DHCS Ground Emergency Medical Transport Quality Assurance Fee webpage for more information.