CommercialPrior AuthHigh impact
25-1149 Behavioral Health Authorization Submission Guidelines
Health Net·CA · Psychiatry·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Starting January 1, 2026, Health Net requires behavioral health providers to use Availity Essentials as the primary method for submitting initial facility-based authorization requests for Ambetter HMO/PPO, Employer Group plans, and Wellcare By Health Net members. Concurrent requests will require fax submission using new forms.
Action Required
By January 1, 2026: Billing team must register for Availity Essentials accounts at Multi-Payer Portal Registration and complete training through Availity Learning Center. Update workflows to submit all initial facility-based behavioral health authorization requests through Availity Essentials portal instead of fax for Ambetter HMO/PPO, Employer Group HMO/POS/PPO, and Wellcare By Health Net members. Configure system to use fax method (855-663-2244) only as backup. Ensure all requests include written clinical documentation except for post-stabilization care. Failure to use correct submission method may delay authorization processing.