25-395 Relief for Providers Impacted by Southern California Wildfires
Date: 04/29/25
New updates help support you and the members you care for, providing more flexible terms for prior authorizations, claims submission and more
Health Net is applying flexible timeframes for the processes and services described in this update for physicians and other providers in Los Angeles and Ventura counties displaced by recent wildfires.
These changes are in response to All Plan Letter (APL) 25-005 released by the Department of Managed Health (DMHC) on March 19, 2025, which applies to Commercial and Medi-Cal plans only. This APL was issued following the Governor’s State of Emergency in Los Angeles and Ventura counties on January 7, 2025, due to wildfires. Health Net is applying the flexible time frames and services described below to all impacted network providers, including Medicare providers servicing Wellcare By Health Net members.
Flexible terms for displaced providers
The timeline extensions below apply to physicians and other providers displaced by the wildfires in Los Angeles and Ventura counties. Participating physician groups (PPGs) processing prior authorizations or claims on behalf of Health Net must comply with the following timeline extensions:
- Timeline extension for existing prior authorizations – the duration of existing prior authorizations submitted between January 7, 2025, through March 19, 2025, will be extended by 180 calendar days from the standard 90 days.
- Timeline extension for claims submission – the timeframe for contracted and non-contracted providers to submit claims will be extended to 365 days from the date of service beginning January 7, 2025, until the State of Emergency is declared over under California Code of Regulations, title 28, section 1300.71(b).
- Timeline extension for overpayment disputes – if you have been notified by Health Net of an overpayment between January 7, 2025, through March 19, 2025, the minimum time to dispute the overpayment will be extended from 30 working days to 180 calendar days.
Temporary delivery of care in alternate settings
As of March 19, 2025, displaced physicians and other providers may deliver care from appropriate alternative settings, such as mobile clinics or temporary locations, for six months.
Benefits during a disaster web page
Health Net has created a public-facing resource web page for providers to easily access information about benefits available during a disaster. Physicians and other providers do not need to log in to the secure provider portal to access this page.
To view the page, go to Benefits During a Disaster..
Additional information
For more information on APL 25-005, visit APL 25-005: Southern California Fires and Flexibilities to Impacted.Providers (PDF).
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.
Behavioral health providers can call 844-966-0298.
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, Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.
For Medi-Cal, this information applies to Los Angeles county.