22-735m Help Patients Fill Out Health Care Options Forms With the Correct NPI

Date: 08/31/22

This information applies to Physicians and Participating Physician Groups (PPGs).

This information applies to Medi-Cal in Fresno, Kings and Madera counties.

The NPI helps ensure the patient is assigned to their provider of choice

As a reminder, Health Net*, on behalf of CalViva Health, wants to ensure that Medi-Cal beneficiaries can continue with you as their assigned provider when they transition from fee-for service (FFS) Medi-Cal to a managed care plan (MCP). You can help these beneficiaries by making sure they list your National Provider Identifier (NPI) when they fill out a Medi-Cal Managed Care Choice Enrollment Form or Health Care Options (HCO) form.

Include your NPI on the form

Patients who select you as their provider need your NPI to correctly fill out the HCO form. Please assist the member in capturing your NPI number under the “Doctor/ Clinic Code” field of the HCO form.

Using the correct ID number helps prevent the system from auto-assigning the member to a provider they did not select.

Update your information

If a provider is showing as “not accepting new patients” or not accepting a patient’s age group, gender, etc., the HCO system will not be able to assign the patient to their selected provider.

To update your information, contact your contracted participating physician group (PPG) and the PPG will notify the Plan, or you can use the Plan’s online tool by going to provider website  > Working with Health Net (located under “Want to work with us?”), select Provider Demographics Update Form, and add or update your information. If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.