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Registration


How do I register as an Individual Physician?

Please have your license number and tax ID(s) on hand:

  • Go to provider.healthnet.com.
  • Select the Register button.
  • Review Terms of Use, select I Agree to these terms.
  • Select your region(s) and click Continue.
  • Select your account type Physician.
  • Once you select the type of provider, you'll be prompted to select your user type. Select Solo Practitioner.
  • Enter your information into the form and click the Submit button.

In most cases, you'll be able to create your user name and password and log in to access the site immediately. Once you have successfully registered, you'll be able to check claims and eligibility, directly access policies and procedures, quickly locate providers in Health Net's referral network, and view evidence-based medicine guidelines and other clinical resources.

How does a Physician register an end user?

As a registered Physician, you may also create accounts for staff members who need to use provider.healthnet.com:

  • Go to provider.healthnet.com and log in with your user name and password
  • Select the My Account
  • Select Create New User
  • Select New End User option
  • Fill out the registration form
  • Create a user name
  • Select the provider's information for this user
  • If the user needs access to a specific tax ID, check the tax ID
  • Select any additional functions for this user. Eligibility verification is standard
  • If the user needs to conduct claims inquiries, check "Claims Inquiry"
  • Click on the "Submit" button to create the account

Once complete, Health Net will send the new user a confirmation e-mail that will include their temporary password. Please notify the user of his or her new user name that you created on the registration form. For security purposes Health Net does not send the user name and password together.

How does a Physician register a Delegated Administrator?

As a registered Physician, you may also create a Delegated Administrator for your practice:

  • Go to provider.healthnet.com and log in with your user name and password
  • Select My Account
  • Select Create New User
  • Select Delegated Administrator option
  • Fill out the registration form
  • Create a user name
  • Select the provider's information for this user
  • If the user needs access to a specific tax ID, check the tax ID
  • Click on the "Submit" button to create the account
  • Once complete, Health Net will send the new delegated administrator account user a confirmation e-mail that will include their temporary password. You will need to notify this user of his or her new user name. For security purposes Health Net does not send the user name and password together.

Delegated Administrators can set up users for the organization and assign them roles. Due to security reasons, delegated administrator must establish an end user account for themselves in order to access patient-related information.

How do I register as a Physician, Medical Group, Hospital, or Ancillary Delegated Administrator?

Please have your license number and tax ID(s) on hand:

  • Go to provider.healthnet.com
  • Select the Register button
  • Review Terms of Use, select "I Agree to these terms" and "Continue"
  • Choose your region(s) and "Continue"
  • Select your account type:
    • Physician (click Delegated Administrator option)
    • Medical Group
    • Hospital
    • Ancillary Facility
  • Enter your information into the form and click the "Submit" button to submit your request for verification
  • Print out the confirmation message with your transaction ID and keep it in a secure location. The registrant will need the transaction ID to complete registration.
  • Once your request is verified and approved, you will receive an email from Health Net with a link to complete registration with the specified transaction ID.

Delegated Administrators can set up users for their organization and assign them roles. Due to security reasons, delegated administrator must establish an end user account for themselves in order to access patient-related information.

How do I create End User accounts?

Note: you must be a Delegated Administrator to perform this function

To Establish an End-User Account (Including Your Own):

  • Log in to provider.healthnet.com using your user name and password
  • Select My Account
  • Select Create New User
  • Fill out the registration form
  • Create a user name
  • Select the provider's information for this user
  • If the user needs access to a specific tax ID, check the tax ID
  • Select any additional functions this for this user. Eligibility verification is standard.
  • If the user needs to conduct claims inquiries, check "Claims Inquiry"
  • Click on the "Submit" button to create the account
  • Once complete, Health Net will send a confirmation e-mail to the new provider user account that will include the temporary password. For security purposes Health Net does not send the user name and password together.

If you established an account for yourself, log out of the site and log back in with the new Provider User's user name and temporary password. You will now have access to additional features that are not available to you as the delegated administrator.

New End Users: Logging in for the first time
  • Go to provider.healthnet.com
  • Click the Log In button
  • Enter the user name which was provided by your administrator and the temporary password received by email from Health Net
  • Review Terms of Use, select "I Agree to these terms" and "Continue"
  • Change password, please have a temporary password readily available
  • Choose password hint question and create answer
  • You will then be able to access and utilized provider.healthnet.com
All Other Users

Please contact your physician or delegated practice administrator to create your account access.

What is an Account Type?

There are several different types of accounts for provider.healthnet.com: Physician, Hospital, Medical Group, or Ancillary Provider. Select the appropriate provider type and then you will be prompted to select a User type.

Upon submission of my registration request online, will I have immediate access to provider.healthnet.com?

Most individual physicians will have immediate site access. In the event that a license or tax ID numbers does not match the numbers on file with Health Net, your registration will be performed manually with a goal to approve your request within two business days.

Requests for registration as a Hospital, Medical Group, Ancillary Provider or Physician Delegated Administrator must be processed and approved by Health Net. You will receive an email from us confirming that your account is approved. You will then be able to create your account user name and password. Our goal is to turn these around within two business days.

If I register myself as a delegated administrator for the site, will I have access to all its features?

Delegated administrators may only administer accounts and assign access roles to other end users in your office. In order to access all functionality i.e. claims inquiry; you will need to give yourself access by registering yourself as an end user, after you have established your access as the delegated administrator.

As the delegated administrator, how do I set up/register other end users in my office to use the Health net website?
  • Log into provider.healthnet.com with your user name and password.
  • Select My Account
  • Select Create New User and fill out the on-line form to determine access rights.
Who can I contact to get help with registration?

Please contact Provider Services on-line for assistance or more information.

I do not see all the providers for the umbrella Tax ID. How do I get my access updated?

Please contact your delegated administrator. The delegated administrator may update your access with the following steps.

  • Log into provider.healthnet.com with your username and password
  • Select My Account
  • Select Manage Users
  • Search for the user account to update
  • Click on the row of the account to edit
  • Select the provider's information for this user
  • If the user needs access to a specific tax ID, check the tax ID
  • If the user needs access to specific provider(s) under the tax ID, select the "Individual Providers" checkbox.
  • Select a provider or multiple providers and use the right arrow button to move the selections to the right hand column.
  • Save changes
I am a delegated administrator and I am missing a Tax ID on my account. How do I get my access updated?

Please contact Health Net Provider Support

Can anyone create an administrative account?

Anyone can attempt to create an account, but all registrations are subject to Health Net verification. Registrants can't access the site until after they've gone through a stringent and secure approval process.

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General Purpose
Health Net's National Medical Policies (the "Policies") are developed to assist Health Net in administering plan benefits and determining whether a particular procedure, drug, service, or supply is medically necessary. The Policies are based upon a review of the available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the drug or device, evidence-based guidelines of governmental bodies, and evidence-based guidelines and positions of select national health professional organizations. Coverage determinations are made on a case-by-case basis and are subject to all of the terms, conditions, limitations, and exclusions of the Member's contract, including medical necessity requirements. Health Net may use the Policies to determine whether, under the facts and circumstances of a particular case, the proposed procedure, drug, service, or supply is medically necessary. The conclusion that a procedure, drug, service, or supply is medically necessary does not constitute coverage. The Member's contract defines which procedure, drug, service, or supply is covered, excluded, limited, or subject to dollar caps. The policy provides for clearly written, reasonable and current criteria that have been approved by Health Net's National Medical Advisory Council (MAC). The clinical criteria and medical policies provide guidelines for determining the medical necessity criteria for specific procedures, equipment and services. In order to be eligible, all services must be medically necessary and otherwise defined in the Member's benefits contract as described in this "Important Notice" disclaimer. In all cases, final benefit determinations are based on the applicable contract language. To the extent there are any conflicts between medical policy guidelines and applicable contract language, the contract language prevails. Medical policy is not intended to override the policy that defines the Member's benefits, nor is it intended to dictate to providers how to practice medicine.


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The Policies do not constitute medical advice. Health Net does not provide or recommend treatment to Members. Members should consult with their treating physician in connection with diagnosis and treatment decisions.


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The Policies do not constitute authorization or guarantee of coverage of any particular procedure, drug, service, or supply. Members and providers should refer to the Member contract to determine if exclusions, limitations and dollar caps apply to a particular procedure, drug, service, or supply.


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Statutory Notice to Members: The materials provided to you are guidelines used by this plan to authorize, modify or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract. The determination of coverage for a particular procedure, drug, service, or supply is not based upon the Policies, but rather is subject to the facts of the individual clinical case, terms and conditions of the Member's contract, and requirements of applicable laws and regulations. The contract language contains specific terms and conditions, including pre-existing conditions, limitations, exclusions, benefit maximums, eligibility, and other relevant terms and conditions of coverage. In the event the Member's contract (also known as the benefit contract, coverage document, or evidence of coverage) conflicts with the Policies, the Member's contract shall govern. The Policies do not replace or amend the Member contract.


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The determinations of coverage for a particular procedure, drug, service, or supply is subject to applicable legal and regulatory mandates and requirements. If there is a discrepancy between the Policies and legal mandates and regulatory requirements, the requirements of law and regulation shall govern.


Reconstructive Surgery
California Health and Safety Code 1367.63 requires health care service plans to cover reconstructive surgery. "Reconstructive surgery" means surgery performed to correct or repair abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following:


1. To improve function; or
2. To create a normal appearance, to the extent possible.


Reconstructive surgery does not mean "cosmetic surgery," which is surgery performed to alter or reshape normal structures of the body in order to improve appearance.


Requests for reconstructive surgery may be denied, if the proposed procedure offers only a minimal improvement in the appearance of the enrollee, in accordance with the standard of care as practiced by physicians specializing in reconstructive surgery.


Reconstructive Surgery after Mastectomy
California Health and Safety Code 1367.6 requires treatment for breast cancer to cover prosthetic devices or reconstructive surgery to restore and achieve symmetry for the patient incident to a mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the copayment, or deductible and coinsurance conditions, that are applicable to the mastectomy and all other terms and conditions applicable to other benefits. "Mastectomy" means the removal of all or part of the breast for medically necessary reasons, as determined by a licensed physician and surgeon.


Policy Limitations: Medicare and Medicaid
Policies specifically developed to assist Health Net in administering Medicare or Medicaid plan benefits and determining coverage for a particular procedure, drug, service, or supply for Medicare or Medicaid Members shall not be construed to apply to any other Health Net plans and Members. The Policies shall not be interpreted to limit the benefits afforded Medicare and Medicaid Members by law and regulation.

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Document Type - File naming convention
PPG Care Plans - careplan_hnsubidpersonid_yyyymmdd.pdf
CBAS Care Plan - cbascp_hnsubidpersonid_yyyymmdd.pdf
CBAS Assessment - cbasa_hnsubidpersonid_yyyymmdd.pdf
MSSP Assessment - msspa_hnsubidpersonid_yyyymmdd.pdf
MSSP Care Plan - msspcp_hnsubidpersonid_yyyymmdd.pdf
MSSP Connect the Needs Assessment - mctna_hnsubidpersonid_yyyymmdd.pdf
MSSP Connect the Needs Care Plan - mctncp_hnsubidpersonid_yyyymmdd.pdf
SNF MDS Form - snfmds_hnsubidpersonid_yyyymmdd.pdf
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