22-203 See What News Is Online for February 2022
Date: 03/07/22
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.
Go to the Provider Library for the latest information that can help you do business with us
The table below outlines communications posted in the Provider Library in February 2022. It includes the posting date, material number and title, type of notice, applicable audience and counties, and a summary of the communication.
Access the Provider Library
Use either option below to access the Provider Library. Once in the library, select a line of business, then select Updates and Letters to view the communications referenced in this update in their entirety.
Option 1
- Log in to the provider portal.
- Select Provider Library under Quick Links.
Option 2
Go directly to the provider library.
Date posted | Number and title | Type of notice | Audience | Lines of business1 | Summary |
|---|---|---|---|---|---|
February 4, 2022 | 22-094m, Stay Informed on Quality Goals and Activities to Improve the Health of Members | News & Announcements |
|
| The Quality Improvement Program monitors performance of clinical care and service measures using many internal and external health care data collection systems. Refer to this provider update for more information about quality improvement support, programs and performance goals comparisons to 2020. |
February 14, 2022 | 22-073m, Help Your Patients Stay on Their Medication Therapy Plan | News & Announcements |
|
| Refer to this tip sheet when discussing with your patients their medications and ways to overcome obstacles to following their medication therapy plan. |
February 15, 2022 | 22-125m, New to Health Net? Check Out Your New Welcome Packet! | News & Announcements |
|
| The Commercial and Wellcare By Health Net new provider welcome packet is available for download or print online at provider.healthnet.com under Resources For You. Topics include but are not limited to claims processing, prior authorization, pharmacy, appeals and grievances, and more. |
February 24, 2022 | 22-159m, Verify Member Eligibility with IVR Self-Service Tool | News & Announcements |
|
| This update helps educate providers on what to expect when using the IVR self-service tool to verify member eligibility. |
February 28, 2022 | 22-190m, It’s Easy to Request Authorizations and Submit Claims for Medicare Advantage PPO Members | Contractual |
|
| This Update reminds providers that the Wellcare No Premium Open (PPO) plan was added for members in Amador and Sutter counties effective January 1, 2022. This was originally communicated in provider update 21- 759, Introducing Wellcare by Health Net’s New Medicare PPO, distributed on October 27, 2021, with information about authorizations, referrals, claims submission, and eligibility. How to access provider update 21-759 in the Provider Library is included. |
February 28, 2022 | 22-194m, Help Tailor Services and Programs for At-Risk Members with New Social Determinants of Health Codes | News & Announcements |
|
| This update informs providers about the seven new priority Department of Health Care Services’ (DHCS’) social determinants of health (SDOH) codes that were added to the original 18 SDOH priority codes effective February 3, 2022, per APL 21-009 (revised). Data is gathered from SDOH codes that providers add to claims and encounters to better plan and coordinate care for at-risk members. This is part of the CalAIM population health management initiative. |
1 Medi-Cal (all counties) indicates that the communication applies to Medi-Cal Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Additional information
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center within 60 days, by phone or through the provider website as listed below.
Line of Business | Telephone Number | Provider Portal | Email Address |
|---|---|---|---|
EnhancedCare PPO (IFP) | 1-844-463-8188 |
| provider_services@healthnet.com
|
EnhancedCare PPO (SBG) | 1-844-463-8188 | ||
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 1-800-641-7761 | ||
IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO) | 1-888-926-2164 | ||
Medicare (individual) | 1-800-929-9224 | ||
Medicare (employer group) | 1-800-929-9224 | ||
Medi-Cal | 1-800-675-6110 | N/A |