Skip to Main Content

24-1336 Annual Review and Updates to the Medi-Cal Provider Operations Manual

Date: 12/30/24

To meet Medi-Cal contract requirements, Health Net has conducted a comprehensive annual review of the Medi-Cal provider operations manual.

Key revisions

Based on this comprehensive review, relevant sections of the Medi-Cal provider operations manual have been revised as needed to align with Medi-Cal contract requirements and contractual, administrative and plan updates and changes.

The sections with changes can be found below this communication.

Additional information

For the latest and most updated information, access the Medi-Cal Provider Operations Manual.   

If you have questions regarding the information contained in this update, contact the Health Net Medi-Cal Provider Services Center at 800-675-6110.

Updated Medi-Cal provider operations manual sections.

Section

Adverse Childhood Experiences (ACEs)

Benefits

Claims and Provider Reimbursement

Claims Coding Policies

Compliance and Regulations

Consent

Coordination of Benefits

Credentialing

Denial Notification

Disenrollment

Appeals, Grievances and Disputes

Emergency Services

Medical Records

Member Rights and Responsibilities

Prior Authorizations

Provider Oversight

Public Programs

Quality Improvement

Referrals

Urgent Care

Utilization Management

 

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary Providers.

For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.



Last Updated: 12/28/2024