23-486 Ensure Patient's Health Information Forms (HIF) are Submitted to the Correct Address

Date: 05/30/23

Help your patients complete their HIF and act on positive screening results

The California Department of Health Care Services, Managed Risk Medical Insurance Board and Centers for Medicare and Medicaid Services require primary care providers (PCPs) to conduct an Initial Health Appointment (IHA) with every newly enrolled member within 90 days of being assigned as the member’s PCP.  Federal regulations require PCPs to report positive screening results to Health Net using the HIF within 90 days of a member being assigned to the PCP.

Where can you get the HIF?

HIF forms can be downloaded at: Your Personal Wellness Assessment (PDF). Once completed, keep a copy in the member’s chart and send the form to Health Net’s new address at:

Medical Management Notifications
P.O. BOX 2010
Farmington, MO 63640-9706

What does HIF do for my patients?

The HIF will help identify any positive screens, extra needs or services your patient may require such as transportation, housing, access to food, their self-perception of health, and impairments related to activities of daily and independent living. We will incorporate the responses from these forms into our risk stratification algorithm for provision of timely services and supports.

For questions on how to help your patient complete the HIF, visit or contact Member services using the number on the back of the member ID card.

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), Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.

For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.