23-1026 Go Online to Find Updates to Medical Policies
Date: 09/08/23
Starting in September, new and updated medical policies will be available each month and online for quick access
As of September 2023, Health Net will notify physicians and other providers of new and updated medical policies each month instead of quarterly. You can access the monthly communication online in the Provider Library at provider library > select a line of business > Updates and Letters.
As a reminder, medical policies offer guidelines for determining medical necessity for certain procedures, equipment and services, and can be accessed at Health Net Medical Policies. All services must be medically necessary and member benefits, legal and regulatory mandates take precedence over content of medical policies and must be applied first.
Look for the monthly provider update to find the latest medical policies communication
The medical policies communication will be included in the monthly provider update that we fax, mail or email each month.
Our monthly provider update notifies you of communications that have been posted in the Provider Library in the preceding month. It includes instructions for accessing the Provider Library, and a table of communications available online, including their:
- Posting date.
- Material number and title.
- Type of notice (Contractual, Regulatory, Legislative, News & Announcements).
- Applicable audience and Medi-Cal counties.
- Summary of the notice.
What’s the upside to this change?
- More immediate notification of new and updated policies. Changing from a quarterly to a monthly notice will help provide prompt guidance to help you determine medical necessity for procedures and services.
- Helps cut down on volume of provider communications you receive. Posting the medical policies communication online each month helps reduce the volume of provider communications you receive from us by fax, mail or email.
Additional information
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by telephone or through the Health Net provider portal.
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.