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Salud con Health Net

Provider Type

  • Physicians 
  • Participating Physician Groups (PPG)
    (does not apply to HSP)
  • Hospitals

Health Net is responsible for processing all claims under Salud con Health Net EPO and PPO plans as follows:

  • Medico Hispano/Clinica Medica General providers submit claims to their IPA per established process. The IPA batches the claims and forwards them directly to Health Net for processing
  • Lakewood Regional Hospital (Tenet facility) submits claims directly to Health Net for processing
  • Sistemas medicos Nacionales S.A. de C.V (SIMNSA) providers send their claims to SIMNSA, which forwards the claims to Health Net
  • Salud con Health Net PPO providers in California send their claims directly to Health Net PPO Claims
  • Out-of-network providers in Mexico send their claims to SIMNSA, which generates any needed denial letters
  • Out-of-network providers in California send their claims to Health Net PPO Claims or Health Net EPO Claims for payment as applicable

For more information, select any subject below:

Last Updated: 10/30/2019