25-359 Streamlined Transactions with New Features on the Availity Essentials Provider Portal
Date: 04/11/25
Register with Availity EssentialsTM to access powerful new functionalities starting April 2025
Health Net has partnered with Availity Essentials to simplify provider portal operations and transactions. With an Availity Essentials account, you can already take advantage of numerous features, including:
- Checking member benefits and eligibility
- Submitting and tracking claims
- Submitting prior authorizations
- Accessing specific payer resources
Using the Availity Essentials provider portal is optional and not required. You can continue to access the existing Health Net secure provider portal, just as you do today.
New features launching April 21, 2025
Exciting new functionalities will soon make managing your provider operations even more seamless. Here's what you can look forward to:
- Easily correct claims: Modify and resubmit paid or denied claims directly from the Claim Status Response page. (Note: Your organization’s Availity Essentials Administrator must assign you the Claim Status role to enable this feature.)
- Enhanced remittance search: Simplify reconciliation with advanced search and filter options for locating remittances.
- Download a Check Summary: View and reconcile detailed remittance data in an easy-to-read format for claims linked to a check or electronic funds transfer (EFT). (Note: Your organization’s Administrator must validate a payment received in the past 30 days before granting access to the Claim Status role to view remittances.)
- Facilitate authorizations: Use the “Take Me to InterQual” button to help facilitate the authorization review process.
- Manage member follow-up care: The primary care physician (PCP) notifications alert you of a member’s admission, discharge, and hospital transfer status to help you provide follow-up care. (Note: This functionality is available for Medi-Cal only.)
Accessing plan-specific crosswalks
Plan-specific crosswalks, which outline available features by plan, are now accessible on Availity Essentials. Here's how to find them:
- Log in to Availity Essentials
- Search for “Crosswalks for Centene health plans"
- Expand the California section
- Download the crosswalk
Provider training opportunities
Take full advantage of these new features by participating in live or recorded training sessions available in the Availity Learning Center. To access these sessions, log in to Availity Essentials and select Get Trained under the Help & Training section.
I am not registered with Availity Essentials
Your organization’s designated Availity Essentials administrator is the person responsible for registering your organization in Availity Essentials and managing user accounts. This person should have legal authority to sign agreements for your organization. To create an account, follow the instructions in the table below.
If you… | Then… |
|---|---|
Are the administrator |
Once you have registered for an account, you will receive email communications directly from Availity Essentials. |
Are not the administrator | Your designated Availity administrator will determine who needs access to Availity Essentials on behalf of your organization and will add and manage user accounts. |
Are not sure who is the administrator | Share this information with your manager to help determine who will be the designated Availity administrator for your organization. |
I’m already registered with Availity Essentials
If you already have an Availity Essentials account, log in using your existing credentials.
Stay updated with future communications
Starting April 2025, you will receive direct email communications from Availity Essentials, keeping you informed about new features and training opportunities. Ensure you’re registered with Availity Essentials to stay in the loop.
Additionally, Health Net will provide direct updates about any further enhancements to the Availity Essentials provider portal, as needed.
Additional information
If you need assistance with your Availity Essentials registration or have questions regarding information contained in this communication, contact Availity Client Services at 800-282-4548, Monday through Friday, 5 a.m. – 5 p.m. PT.
For other general questions, contact the Provider Services Center by email, by phone or through the provider portal.
Provider Services
Line of business | Phone number |
|---|---|
Ambetter from Health Net IFP Ambetter PPO | |
Ambetter HMO | |
Health Net Employer Group HMO, POS, & PPO | |
Medicare (Individual & Employer Group) (Wellcare By Health Net) | |
Medicare Supplement | |
Medi-Cal (including CS and ECM providers) |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.