MedicaidPrior AuthMedium impact
25-817 Provider Communications Posted Online and Operations Manual Updates for July 2025
Health Net·CA · Psychiatry·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net California posted July 2025 provider communications and operations manual updates, including new prior authorization requirements through Availity Essentials portal for behavioral health services effective July 1, 2025. Multiple operational updates were made regarding sensitive services billing, peer-to-peer review contacts, and provider compliance requirements.
Action Required
Immediately: Billing team must begin using Availity Essentials provider portal to request prior authorization for certain behavioral health services in Imperial County. Update staff training on new peer-to-peer review contact information. Review updated sensitive services billing guidelines for rape and sexual assault cases. Ensure participation in required regulatory surveys to maintain compliance.