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Updates and Letters

Amendments to the information in these manuals are made through updates or signed letters distributed by fax, the United States Postal Service or other carrier and email.

18-012 – Treating and Managing Behavioral Health Conditions Primary Care Provider Toolkit is Available Online (PDF)

18-021 – Hospital Physician Network Report (PDF)

18-022 – Ancillary Provider Data Verification Update-wave 3 (PDF)

18-038 – Selecting Product Type Required to Check Member Eligibility on the New Provider Portal (PDF)

18-045 – Group Number is Not Required for Claims Submission and Reminder to Register for PaySpan (PDF)

18-056 – Action Requested: Invitation to Register for Upcoming Provider Webinars (PDF)

18-062 – After-Hours Access Guidelines and Access to Urgent/Emergent Services (PDF)

18-066 – Improving Health Literacy (PDF)

18-090 – Expanded Benefit for 3-D Mammography (PDF)

18-091 – Childhood Lead Poisoning Screening is a Covered Preventive Service (PDF)

18-102 – Dedicated Telephone Line for Inquiries Regarding EHS Medical Group and Multicultural Medical Group Termination (PDF)

18-107 – Electronic Claims Submission Guidelines (PDF)

18-109 – New IVR Self-Service Tool for Health Net Covered California and Indicidual Family Plan Members (PDF)

18-110 – 2018 PPG Webinar Calendar (PDF)

18-113 – Overdose Education and Naloxone Webinar Series (PDF)

18-116 – Continuity of Health Care Coverage (PDF)

18-122 – Medication Trend Updates and Formulary Changes – 1st Quarter 2018 (PDF)

18-131 – Medical Policies - 4th Quarter 2017 (PDF)

18-140 – Important Prior Authorization Request and Hospital Notification Contacts (PDF)

18-143 – ACA Encounter Data Submission Deadlines for 2017 Final Payment (PDF)

18-164 – Upcoming Provider Webinar: Best Practices to Support Vaginal Delivery and Reduce the NTSV Cesarean Section Rate (PDF)

18-166 – Ancillary Provider Data Verification Update-wave 4 (PDF)

18-181 – Non-Participating Hospitals Notification for ER Admission for Post-Stabilization Services Letter (PDF)

18-198 – Behavioral Health Documentation Standards (PDF)

18-201 –  Timely Provider Data Demographic Data Validation Reminder (PDF)

18-213 – Alternative Treatments for Low Back Pain (PDF)

18-218 – Claims Receipt Date Format for Electronic and Paper Claim Forms for Individual Medicare Advantage and IFP Claims (PDF)

18-221 – Medications Newly Approved by the U.S. Food and Drug Administration (PDF)

18-225 – After-Hours Access Guidelines and Access to Urgent and Emergent Services (PDF)

18-234 – Provider Webinar – Decreasing NTSV Cesarean Section Rates (PDF)

18-247 – Ancillary Provider Data Verification Update-Regional (PDF)

18-268 – Quality Management Program (PDF)

18-272 – Influenza and Streptococcus Group A Testing Clinical Policy Change (PDF)

18-275 – Beverly Hills Cancer Center and Optima Diagnostic Imaging Added to PPO Network (PDF)

18-287 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-290 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2018 (PDF)

18-298 – Notification of Hospital Admissions (PDF)

18-334 – HEDIS Well-Child Visits in the First 15 Months of Life  Measure - Tip Sheet Update (PDF)

18-351 – 2018 Provider Appointment Availability & After-Hours Survey Prep (PDF)

18-356 – Partial fill schedule II drug prescriptions (PDF)

18-362 – Hospital Provider Data Verification Update (PDF)

18-372 – Submitting Medical Prior Authorization Requests (PDF)

18-382 – Provider Appeals Informationa nd Documentation Requirements (PDF)

18-388 – Medical Policies - 1st Quarter 2018 (PDF)

18-391 – MY2018 Behavioral Health Provider Appointment Availability Survey (PDF)

18-441 – Provider Demographic Data Validation -Q2 (PDF)

18-444 – Medical Paper Claims Submission Rejections and Resolutions (PDF)

18-447 – Secure Messaging Changes (PDF)

18-453 – State of Emergency: Health Net Members Impacted by Pawnee Fire in Lake County (PDF)

18-460 – Language Assistance Program and Cultural Competency (PDF)

18-461 – Language Assistance Program and Cultural Competency (PDF)

18-479 – Health Net Implements New Clinical Payment Policies (PDF)

18-485 – Recovered Functionality and Improving Customer Service (PDF)

18-490 – State of Emergency: Health Net Members Impacted by West Fire in San Diego County (PDF)

18-492 – State of Emergency: Health Net Members Impacted by Holiday Fire in Santa Barbara County (PDF)

18-496 – State of Emergency: Health Net Members Impacted by Klamathon Fire in Siskiyou County (PDF)

18-541 – Paper Claims Submission Adress and Provider Appeals Address (PDF)

18-543 – State of Emergency: Support for Health Net Members Impacted by Carr Fire in ShastaCounty (PDF)

18-544 – State of Emergency: Support for Health Net Members Impacted by Cranston Fire in Riverside County (PDF)

18-550 – State of Emergency: Support for Health Net Members Impacted by Ferguson Fire in Mariposa County (PDF)

18-552 – Promoting HN's Community Resource Center in LA (PDF)

18-554 – State of Emergency: Support for Health Net Members Impacted by Steele Fire in Napa County (PDF)

18-555 – State of Emergency: Support for Health Net Members Impacted by River Fire and Ranch Fire in Mendocino and Lake Counties (PDF)

18-558 – Updated Contract Language Required for NCQA Health Plan Accreditation (PDF)

18-563 – MY2017 Behavioral Health Provider Appointment Availability Survey Results (PDF)

18-564 – Submitting Claims with Member Identification Number Starting with R and AK Rejection Code (PDF)

18-572 – Accessing the Schedule of Benefits (PDF)

18-577 – Use the Correct Entity name for Paper Claims Submission (PDF)

18-580 – State of Emergency: Support for Health Net Members Impacted by Holy Fire in Orange and Riverside Counties (PDF)

18-581 – Prior Authorization Requests – Fax Criteria (PDF)

18-583 – Medication Trend Updates and Formulary Changes – 3rd Quarter 2018 (PDF)

18-586 – 2017 Provider Appointment Availability and After-Hours Access Survey Results (PDF)

18-589 – Provider Responsibility for Verifying Eligibility for IFP Members in Grace Period for Nonpayment of Premium (PDF)

18-591 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF)

18-611 – Upcoming 2018 Provider Satisfaction Survey (PDF)

18-615 – Explanation of Payment/Remittance Advice Challenges and Suggested Solutions (PDF)

18-621 – Verifying Eligibility (IFP) (PDF)

18-623 – Provider Offshore Subcontracting Requirements Annual Reminder (PDF)

18-635 – Opioid Use (or Miisuse) in Pregnancy & Treatment Webinar (PDF)

18-638 – PPO Group Member Transition to MHN (PDF)

18-659 – Medical Policies - 1st Quarter 2018 (PDF)

18-673 – Provider Update - Importance of Developmental Screenings (PDF)

18-676 – Omada Flyer (PDF)

18-685 – Timely Response to Request for Medical Records Reminder (PDF)

18-689 – Corrected Individual Family Plan Prior Authorization Request Form (PDF)

18-691 – Best Practices Flu Vaccine Flyer (PDF)

18-721 – Concurrent Reviews (PDF)

18-725 – Learning Collaborative to Improve HPV Immunization Rates (PDF)

18-728 – Provider Demographic Data Validation -Q3 (PDF)

18-748 – HEDIS Annual Medical Record Collection (PDF)

18-753 – Serogroup B Meningococcal Outbreak at San Diego State University (PDF)

18-756 – How to Navigate The New Provider Portal Webinars (PDF)

18-771 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-775 – Single Member ID Now Displaying on the Provider Portal (PDF)

18-778 – Health Net Implements New Payment Integrity Policies (PDF)

18-782 – Meningococcal Serogroup B Vaccine Inventory Information Needed (PDF)

18-783 – Website and Account Manager Access at provider.healthnetcalifornia.com (PDF)

18-786 – Medication Trend Updates and Formulary Changes - 4th Quarter 2018 (PDF)

18-797 – Prior Authorization Requirement Changes (PDF)

18-802 – Whooping Cough Epidemic Anticipated for 2018 (PDF)

18-808 – Collaborative Care Supports Cesarean Reduction - Provider Webinar (PDF)

18-816 – Cost Comparison Tool Transitions to HealthSparq on January 1, 2019 (PDF)

18-824 – 2018-2019 Influence Vaccine Recommendations (PDF)

18-836 – Health Net to Use Verify Health Care Portal to Conduct Provider Data Verification (PDF)

18-844 – Reversing Opioid Depression with Naloxone Hydrochloride (PDF)

18-850 – State of Emergency: Hill and Woolsey Fires in Los Angeles and Ventura Counties (PDF)

18-856 – Provider Demographic Data Validation - Q4 (PDF)

18-864 – Depression Screening and Follow-up Plan for Adolescents and Adults (PDF)

18-874 – Medical Policies - 3rd Quarter 2018 (PDF)

18-879 – LexisNexis to Conduct Provide Data Verification for PPGs (PDF)

18-880 – HEDIS®   Quality Measures for Patient Opioid Use (PDF)

18-884 – URGENT: Telehealth Services for California Fire Victims (PDF)

18-890 – Directory Accuracy, Why is this so Hard? Webinar (PDF)

18-901 – State of Emergency: Additional Information for Members Impacted by Camp Fire (PDF)

18-927 – Claims Rejection Letters to Be Sent Beginning December 26, 2018 (PDF)

19-002 – Are You Ready for the CAHPS Survey? (PDF)

19-021sum – Verify Eligibility for IFP Members in a Premium Grace Period (PDF)

19-021 – Verify Eligibility for IFP Members in a Premium Grace Period (PDF)

19-039 – Nonopioid Medication Options & Nonpharm Treatment (PDF) 

19-043 – Sign Up for 2019 Educational Webinars (PDF)

19-067 – Transitioning Delegated Functions (PDF)

19-074 – Inpatient Notification Requirements (PDF)

19-087 – Use of Tamper-Resistant Controlled Substance Prescription Forms Delayed (PDF)

19-094 – Support for Providers Treating Pattients with Opiod Use Disorder (PDF)

19-110 – Expanded Criteria for Co-Prescribing Naloxone (PDF)

19-127 – Medical Policies - 4th Quarter 2018 (PDF)

19-135 – Sharing Medical Records at Health Net’s Request (PDF)

19-149 – Avoid Authorization Denials by Submitting Requested Medical Records to NIA (PDF)

19-168 – Requesting Medical Records from PPGs' Individual Practitioners (PDF)

19-171 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer (PDF)

19-178 – State of Emergency: Counties Across California Due to Winter Storms (PDF)

19-181 – State of Emergency: 4 Additional Counties Across California Due to Winter Storms (PDF)

19-238 – AB 2193 Requires Maternal Mental Health Screening (PDF)

19-242 – Best Practices Prescribing and Managing Opioid Medications (PDF)

19-255 – Timely Provider Demographic Data Validation Reminder (PDF)

19-303 – Nonpar Hospital ER Admission Post-stabilization Notification (PDF)

19-310 – Ultomiris™ Approved by FDA (PDF)

19-362 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 2 (PDF)

19-391 – Pertussis Death in California (PDF)

19-397 – Measles Outbreak Plagues California (PDF)

19-418 – Measles Outbreak Plagues California (PDF)

19-430 – Patient Education Tips for Opioid Therapy (PDF)

19-438 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2019 (PDF)

19-466 – LA County Measles Outbreak (PDF) 

19-483 – Send Medical Records If Requested for Emergency Claims to Avoid Delays (PDF)

19-486 – Taper Off Opioids to Avoid Harm (PDF

19-502 – Encounters Training for Providers (PDF)

19-515 – Reminder: Verify Eligibility for On-Echange IFP Members in a Premium Grace Period to Avoid Claims Payment Issues (PDF)

19-525 – Medical Policies - 1st Quarter 2018 (PDF

19-533 – Advanced Access Flyer (PDF)

19-537 – Timely Provider Demographic Data Validation Reminder (PDF)

19-556 – Improve Your Access and Availabiltiy Provider Online Trainging Flyer (PDF)

19-565 – Language Assistance Program and Cultural Competency Services (PDF)

19-567 – Get ready for the CAHPS survey (PDF)

19-571 – Pain Management and Opioids CME flyer (PDF)

19-576 – Labcorp- Walgreen Draw Sites (PDF)

19-605 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 3 (PDF)

19-626 – Improve Quality of Care and Reduce Readmissions through Safe Hospital Discharge (PDF)

19-643 – Refer Patients to myStrength.com for Pregnancy and Early Parenting Support (PDF)

19-651 – Reduce the Number of Heart Attacks and Strokes (PDF)

19-666 – Prior Authorization Requirement Changes (PDF)

19-696 – Medi-Cal 2018 Provider Appointment Availability and After-Hours Access Survey Results (PDF)

19-701 – Medication Trend Updates and Formulary Changes – 3rd Quarter 2019 (PDF

19-725 – Timely Provider Demographic Data Validation Reminder Q3 (PDF)

19-734 – Help Patients Better Control their Asthma and its Triggers (PDF)

19-738 – Feedback Needed – 2019 Provider Satisfaction Survey (PDF)

19-745 – Choose the Right Address for Provider Disputes Sent on Behalf of a Member (PDF)

19-754 – Prepare for the 2019 Provider Appointment Availability and After-Hours Access Survey (PDF)

19-815 – Improve Treatment of OUD in Pregnancy with these Resources (PDF)

19-820 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 4 (PDF)

19-824 – Prior Authorization Requirement Changes (PDF)

19-832 – State of Emergency: Fires in Los Angeles and Riverside Counties (PDF)

19-834 – Medical Policies - 2nd Quarter 2018 (PDF)

19-838 – HEDIS Annual Medical Record Collection (PDF)

19-845 – Submit Professional Anesthesia Encounters with MJ Qualifier (PDF)

19-869 – State of Emergency: Fires in Los Angeles and Sonoma Counties (PDF)

19-871 – State of Emergency Declared throughout the State of California (PDF)

19-879 – Get Ready for the Great American Smokeout on November 21, 2019 (PDF)

19-907 – Bill Telehealth Services Correctly to Receive Timely Payment (PDF)

19-911 – Two New Payment Policies (PDF)

19-916 – Medication Trend Updates and Formulary Changes - 4th Quarter 2019 (PDF)

19-923 – Medical Policies 3rd Qtr 2019 (PDF)   

19-933 – Submit additional Claims Info to PPG When PPG is Financially Responsible (PDF)

19-949 – Your working to treat opioid misuse. Let us help. (PDF)

19-969 – Update Your Demographic Information (PDF)  

19-992 – Refer your Health Net Patients to Adventist Health Tulare (PDF)

19-1010 – Include ASD Screening during Well-Child Visits (PDF)

    UPDATES AND LETTERS FOR 2020 AND BEYOND

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    Last Updated: 05/20/2021