24-542 Prior Authorization Extensions for All Services, Including DME, Ends June 30, 2024
Date: 06/26/24
Time span for approved prior authorizations reverts back to three months post pandemic
During the COVID-19 pandemic, prior authorization time spans were extended to six months after the request was approved. Now that we are past the pandemic, the time span for all services including durable medical equipment (DME) requests will be for three months after approval, unless otherwise noted in an authorization letter. This change goes back to our standard approval time frame in place before COVID-19 and in accordance with your Provider Participation Agreement (PPA).
This is effective on July 1, 2024. Prior authorization requests received on or after July 1 and approved will be for the three months duration, unless noted otherwise in an authorization letter.
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.
Line of business | Phone number | Email address |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO | ||
Medicare (Individual & Employer Group) (Wellcare By Health Net) | ||
Medi-Cal (including CS and ECM providers) | N/A |
This information applies to Physicians, Participating Physician Groups (PPGs), Ancillary Providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, including Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.