22-178 Hospital Physician Network Report

Date: 02/22/22

This information applies to Hospitals

Submit hospital-based specialists report by the second Friday in March and annually thereafter

Health Net is required to submit a hospital physician network report to the California Department of Insurance (CDI) per the California Code of Regulations Title 10, §2240.5(d)(14) Filing and Reporting Requirements.

To comply with this regulation, we are asking Health Net participating hospitals to supply information on hospital-based specialists who practice at a network hospital, but are not in Health Net’s network. Please supply information for the specialties:

• Anesthesiology
• Emergency medicine
• Neonatology
• Pathology
• Radiology

Reporting format and submission

Submit information via Excel spreadsheet by the second Friday in March 2022 and annually thereafter. To ensure clarity, list each specialty on its own tab. Include only the specialties requested above. For each specialty, submit the below information:

Hospital contracting with one group	Hospital contracting with multiple practices (*required fields):
Group name Tax identification number (TIN) The number of providers utilized from the group	Physician name* (last, first name, middle initial) Title License number National Provider Identifier (NPI)* TIN	Specialty* Address City*, State, Zip County

Submit the report to either Health Net's provider contracting deaprtment or the hospital’s Health Net Provider Relations & Contract Specialist (PRCS). If your hospital does not submit a report, your hospital PRCS will contact you for a response.

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center, by phone or through the Health Net provider website.