Administration of Behavioral Health Services Transition from MHN to Health Net
Attention Medi-Cal Providers Only
The claims address and payer ID for Medi-Cal claims for dates of service on or after September 1, 2024, is:
Health Net Medi-Cal Claims
PO Box 9020
Farmington, MO 63640-9020
Payer ID: 95567
Please refer to communications for more details:
- 24-415 – New Claims Submission Information for Medi-Cal Behavioral Health Services – CalViva Health
- 24-416 – New Claims Submission Information for Medi-Cal Behavioral Health Services – Health Net
- 24-417 – New Claims Submission Information for Medi-Cal Behavioral Health Services – Community Health Plan of Imperial Valley
Effective January 1, 2024, behavioral health services have transitioned to Health Net of California, Inc. (Health Net) from MHN. Members will not experience any changes to their behavioral health benefits as a result of this change.
As a reminder, as of January 1, 2024, California Health & Wellness Plan members in Amador, Calaveras, Inyo, Mono, and Tuolumne counties transitioned to Health Net Community Solutions, Inc., (Health Net) and members in Imperial County transitioned to Community Health Plan of the Imperial Valley (CHPIV). As a result of this transition, administration of behavioral health services for these members also transitioned to Health Net.
Members who transitioned to Molina will receive behavioral health benefits from Molina's behavioral health network and will not be managed by Health Net. For detailed information on the 2024 Medi-Cal Department of Health Care Services contract transition in Los Angeles County, refer to the 2024 DHCS Medi-Cal Transition – Health Net and Molina Healthcare membership-sharing Q&As. This resource provides helpful information on member transitions from Health Net to Molina.
The information on this page is intended to serve as a guide for providers impacted by this transition. On this page you will find information, including questions and answers, links to previously distributed provider communications, and provider training and webinars. This page will be updated as new information becomes available.
How does this change in the administration of behavioral health services affect members?
Members will not experience any changes to their behavioral health benefits because of this change. Members have received new member ID cards with updated contact information for behavioral health services as part of the annual member ID re-carding process.
How will you notify members of this change?
Members started receiving notices about this change starting in November 2023.
After January 1, 2024, how do I access online functions to check a member's eligibility or benefits, or check claims status?
You need to have an established account or create a new account with Health Net in order to access certain functions, like member eligibility and benefits checks and claims status, on the secure provider portal.
- If you are an existing Health Net provider and have an account: Log in using your existing Health Net credentials.
- If you are new to Health Net and do not have an existing account: Register here.
- Select Create New Account.
- Follow the prompts until registration is complete.
Where do I submit claims, check eligibility, obtain prior authorization, access the provider operations manual, or find other contact information due to the transition?
Refer to the Behavioral Health Contacts table for contact information related to various functions and operations.
How can I avoid delays with claims payments as a result of this transition?
Every payor's claim system has its unique way to managing intake and processing of claims. The same applies to this migration. Accurate billing information and complete claim submissions are crucial to help avoid potential payment delays for services rendered to eligible members. Please ensure that claims submissions comply with Health Net standards published in provider contracts and manuals.
The table below highlights some critical elements that are often incomplete or missing in provider claim submissions.
| Form Field | Requirements | CMS-1500 (Professional) | UB-04 (Institutional) | Electronic Claims |
|---|---|---|---|---|
| Billing provider name, address and NPI | Enter the name, address, and 10-character NPI ID and taxonomy of the billing entity | Box 33 | Box 1 | Loop NM109 with XX qualifier |
| Subscriber (name, address, DOB, sex, and member ID required) | Enter the subscriber's Health Plan ID exactly as it appears on the member's current ID card. | Subscriber box 1a, 4, 7, 11 | Box 58 and 60 | 2000B and 2010BA |
| Patient (name, address, DOB, sex, relationship to subscriber, status, and member ID) | Enter the member's Health Plan ID exactly as it appears on the member's current ID card. | Patient box 2, 3, 5, 6, 8 | Box 8, 9, 10, 11 | 2000C and 2010CA |
| Attending provider with NPI | Enter the 10-character NPI ID and taxonomy for the attending practitioner. | N/A | Box 76 | Loop 2300 NM1with DN qualifier |
| Rendering provider | Enter the 10-character NPI ID and taxonomy for the individual practitioner who rendered the service (this can be blank if a sole proprietor and that NPI is entered as the Billing Provider). | NPI in Box 24J | Box 56 | Loop 2300 NM1 with 82 qualifier (if differs from billing provider) |
| Service facility information | Enter the name, address, and 10-character NPI ID and taxonomy where the patient service was delivered (this can be blank only if provider is a sole proprietor). | Box 32 | Box 1 | Loop 2310C or 2310E NM1 with 77 qualifiers (if differs from billing provider) |
You can learn more about how we're improving processes for efficient claims and to resolve claims disruptions in the communications below.
- 24-861 – Improved Processes for Efficient Claims Resolution and Streamlined Contacts – Health Net
- 24-862 – Improved Processes for Efficient Claims Resolution and Streamlined Contacts – CalViva Health
- 24-863 – Improved Processes for Efficient Claims Resolution and Streamlined Contacts – Community Health Plan of Imperial Valley
For more information about claim submission, refer to the Behavioral Health Provider Operations Manual (PDF).
Who do I contact with questions or for help?
Contact Behavioral Health Provider Services at 844-966-0298 for questions related to member eligibility, benefits and authorizations.
| Behavioral Health Function | Description and/or Contact |
|---|---|
| Claims submission addresses, payer IDs and claim status check Note: For Medi-Cal claims with overlapping dates of service (DOS), providers must split the claim and submit two separate claims. This does not apply to provider appeals/disputes. Please see Provider disputes for those addresses. | Commercial (Employer Group HMO/POS and PPO): Health Net Commercial Claims P.O. Box 9040 Farmington, MO 63640-9040 Payer ID: 95567 Claim status check: Phone: 800-444-4281 IFP: Health Net Commercial Claims – IFP P.O. Box 9040 Farmington, MO 63640-9040 Payer ID: 68069 Claim status check: Health Net Provider Portal Medicare: Health Net Medicare Claims P.O. Box 9030 Farmington, MO 63640-9030 Payer ID: 68069 Claim status check: Health Net Provider Portal Medi-Cal (includes CalViva Health and Community Health Plan of Imperial Valley): FOR DATES OF SERVICE ON OR AFTER SEPTEMBER 1, 2024 Health Net Medi-Cal Claims P.O. Box 9020 Farmington, MO 63640-9020 Payer ID: 95567 FOR DATES OF SERVICE PRIOR TO SEPTEMBER 1, 2024 Health Net Medi-Cal Claims P.O. Box 14621 Lexington, KY 40512-4621 Payer ID: 22771 Claim Status check: Phone: 800-444-4281 |
| Claims inquiries or questions | Behavioral Health Provider Services Phone: 844-966-0298 |
| Contract renegotiation | Send a request via email to DNBHC@healthnet.com |
| Credentialing questions | Health Net Credentialing Department Email (for facilities): HN_FacilitiesCredentialing@healthnet.com Email (for practitioners): HNCredentialing_Practitioner_CA@Centene.com |
| Eligibility and benefit checks | Health Net Provider Portal |
| Prior authorization | Authorized by Health Net Phone: 844-966-0298 |
| Provider disputes Note: Submit using the Behavioral Health Provider Appeal/Dispute Form (PDF). | Submit to the appropriate address based on the lines of business: Commercial: Health Net Commercial Provider Appeals/Disputes P.O. Box 989882 West Sacramento, CA 95798-9882 IFP: IFP Provider Appeals/Disputes P.O. Box 9040 Farmington, MO 63640-9040 Medicare: Medicare Provider Appeals/Dispute P.O. Box 9030 Farmington, MO 63640-9030 Health Net Medi-Cal, CalViva Health or Community Health Plan of Imperial Valley (address to applicable entity): Health Net Medi-Cal Provider Appeals/Disputes, or CalViva Health Provider Appeals/Disputes, or Community Health Plan of Imperial Valley Provider Appeals/Disputes P.O. Box 989882 West Sacramento, CA 95798-9882 |
| Provider Operations Manual | Behavioral Health Provider Operations Manual (PDF) |
| Request to add or remove sites or practitioners from practice, roster updates | Health Net Provider Data Management Team Email: ProviderData@healthnet.com Include "Behavioral Health and PPG Name (if applicable)" in email subject line. |
| Technical portal support and group administrator requests | Health Net Technical Support Team Phone: 866-458-1047 |
| Update demographic information, Tax ID number, National Provider Identifier, group name, or data that are in the provider directory | Health Net Provider Data Management Team Email: ProviderData@healthnet.com Demographic Update Forms Online Include "Behavioral Health and PPG Name (if applicable)" in email subject line. |
Mandatory training for Medi-Cal providers
Medi-Cal behavioral health providers must complete the Plan's required Medi-Cal training. The training will help you learn about the Plan's critical functions, such as providing or referring members for specific services, submitting claims, member grievances, etc.
Follow the steps below to complete the training, and sign and return the training attestation form before you can be included in Health Net's system of record with an active status date.
- Go to Health Net Medi-Cal New Provider Resources or CalViva Health Medi-Cal New Provider Resources or Community Health Plan of Imperial Valley Medi-Cal New Provider Resources.
- Complete the appropriate training:
- Sign and return the appropriate form by email to HN_Provider_Relations@healthnet.com. Staff members cannot sign the form on behalf of a provider and providers cannot waive required trainings.
Each physician in the office must complete the training and separately submit their own attestation form.
On-demand recorded version of the live webinars
View current and recorded webinars and training materials at any time on the Provider Webinar Information and Training Materials page. Provider webinar topics include Model of Care (MOC), Special Needs and Cultural Competency, and more.
2024
- 24-861 – Improved Processes for Efficient Claims Resolution and Streamlined Contacts – Health Net
- 24-862 – Improved Processes for Efficient Claims Resolution and Streamlined Contacts – CalViva Health
- 24-863 – Improved Processes for Efficient Claims Resolution and Streamlined Contacts – Community Health Plan of Imperial Valley
- 24-590 – Access Resources and Self-Service Tools Online – Health Net (PDF)
- 24-591 – Access Resources and Self-Service Tools Online – CalViva Health (PDF)
- 24-592 – Access Resources and Self-Service Tools Online – Community Health Plan of Imperial Valley (PDF)
- 24-416 – New Claims Submission Information for Medi-Cal Behavioral Health Services – Health Net
- 24-415 – New Claims Submission Information for Medi-Cal Behavioral Health Services – CalViva Health
- 24-417 – New Claims Submission Information for Medi-Cal Behavioral Health Services – Community Health Plan of Imperial Valley
- 24-083 – Updated Claim Submission Information and Behavioral Health Services Transition Reminders – Health Net
- 24-084 – Updated Claim Submission Information and Behavioral Health Services Transition Reminders – CalViva Health
- 24-085 – Updated Claim Submission Information and Behavioral Health Services Transition Reminders – Community Health Plan of Imperial Valley
2023
- 23-1397 – Behavioral Health Medi-Cal Provider Welcome Letter – for Behavioral Health Providers – Health Net (PDF)
- 23-1398 – Behavioral Health Medi-Cal Provider Welcome Letter – for Behavioral Health Providers – CalViva Health (PDF)
- 23-1244 – Important Change: Starting January 1, 2024, Behavioral Health Services will Transition from MHN to Health Net – CalViva Health
- 23-1245 – Important Change: Starting January 1, 2024, Behavioral Health Services will Transition from MHN to Health Net
- 23-1246 – Important Change: Starting January 1, 2024, Behavioral Health Services will Transition from MHN to Health Net (2024 Medi-Cal counties – Amador, Calaveras, Imperial, Inyo, Mono, Tuolumne counties)