24-083 Updated Claim Submission Information and Behavioral Health Services Transition Reminders
Date: 01/18/24
Use the corrected addresses and payer IDs to submit claims
As a reminder, behavioral health services transitioned to Health Net of California, Inc. (Health Net) from MHN on January 1, 2024.
Refer to the information provided below for important details about working with Health Net. This includes corrected claims submission addresses and payer IDs for behavioral health services. New member ID cards will be issued to some members.
You may also select FAQs and Other Resources for Providers to get answers to the most frequently asked questions about this transition.
Corrected claim submission addresses and payer IDs
Behavioral health providers must submit claims, based on the date of service, using the addresses and payer IDs in the table below.
For claims with overlapping dates of service, providers must split the claim for end of year services and submit two separate claims.
IFP (Ambetter HMO and PPO) Marketplace members will receive new member ID cards
Members enrolled in IFP Ambetter HMO and PPO plans (Marketplace) will be sent updated member ID cards in the near future that includes corrected payer ID information.
Be sure to register for an account with Health Net
You will need to create an account with Health Net to access certain functions on the secure provider portal, such as eligibility and benefit checks, and claims status. If you do not have an account, go to provider portal and select Create New Account, then follow the prompts until registration is complete.
Line of Business | Address and Payer ID | |
|---|---|---|
Date of Service On and After | Date of Service Prior to | |
Individual & Family Plan – IFP (Ambetter HMO and PPO) | Health Net Commercial Claims – IFP Payer ID: 68069 Claim status check |
MHN Claims Payer ID: 22771 Claim status check
|
Commercial (Employer Group HMO/POS and PPO) | Health Net Commercial Claims Payer ID: 95567 Claim status check | |
Medicare | Health Net Medicare Claims Payer ID: 68069 Claim status check | |
Medi-Cal | Health Net Medi-Cal Claims Payer ID: 22771 Claim status check | |
Provider Dispute Resolution
The Behavioral Health Provider Dispute Resolution Request form is located at Provider Dispute Resolution Process for California. For provider appeals/disputes, submit to the appropriate P.O. Box listed in the table below:
Line of Business | Address | |
|---|---|---|
Date of Service On and After | Date of Service Prior to | |
Individual & Family Plan – IFP (Ambetter HMO and PPO) | IFP Provider Appeals/Disputes |
MHN Provider Appeals/Disputes |
Commercial (Employer Group HMO/POS and PPO) | Health Net Commercial Provider Appeals/Dispute | |
Medicare | Medicare Provider Appeals/Disputes | |
Medi-Cal | Health Net Medi-Cal Provider Appeals/Disputes | |
Operational and administrative contacts reminder
Use the contacts in the table below for operational and administrative functions that have transitioned to Health Net as of January 1, 2024.
Administrative Functions | Contact Information |
|---|---|
Eligibility and benefit checks | |
Behavioral Health Provider Services For questions related to member eligibility, benefits and authorizations. | Phone: 844-966-0298 |
Provider portal/website | Secure portal: provider protal Public website: Health Net provider resources |
Prior authorization | Authorized by Health Net Phone: 844-966-0298 |
Behavioral Health Provider Operations Manual |
Additional information
Relevant sections of the Behavioral Health Provider Operations Manual have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library on Health Net’s provider portal.
If you have questions regarding the information contained in this update, contact Behavioral Health Provider Services at 844-966-0298.
This information applies to Behavioral Health Providers.
For Medi-Cal, this information applies to Amador, Los Angeles, Calaveras, Sacramento, Inyo, Mono, San Joaquin, Stanislaus, Tuolumne, and Tulare counties.