Salud con Health Net
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- 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: