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25-743m Avoid Returned Requests - Use New Prior Auth Form for RXs and Step-Therapy Exceptions

Date: 08/19/25

There is new contact information for submitting prior authorization requests

A new version of the Prescription Drug Prior Authorization or Step Therapy Exception Request form (No. 61-211) is now available for use on the Health Net provider library under “Forms and References” at:

Please note that requests made with incorrect forms will be returned to the provider or facility for resubmission. When submitting a form for Health Net members, please note the contact information differs based on the line of business for which the prior authorization request is being made.

Prior authorization contact information: Commercial (HMO and PPO)

Prior authorization type

Contact

Fax

Phone

Pharmacy and self-injectable requests

Pharmacy services

 866-399-0929

 800-548-5524

 Option 2

Physician-administered medications

Pharmacy services

 844-235-5090

 800-867-6564

 Option 2

 

Prior authorization contact information: Medi-Cal

Prior authorization type

Contact

Fax

Phone

Self-administered medication requests

Medi-Cal Rx

 800-869-4325

 800-977-2273

Physician-administered medications

Pharmacy services

 833-953-3436

 800-867-6564

 Option 2

 

Additional information

Relevant sections of Health Net’s provider operations manuals 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 the Health Net Provider Services Center by email, by telephone or through the Health Net provider portal.
 

Provider Services

Line of business

Phone number

Email

Ambetter from Health Net IFP

Ambetter PPO

844-463-8188

Provider_services@healthnet.com

Ambetter HMO

888-926-2164

Provider_services@healthnet.com

Health Net Employer Group HMO, POS, & PPO

800-641-7761

Provider_services@healthnet.com

Medi-Cal (including CS and ECM providers)

800-675-6110

N/A

 

This information applies to Physicians and Participating Physician Groups (PPGs).

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



Last Updated: 08/19/2025