CommercialAdministrativeMedium impact
25-540 Mark Your Calendar: New Peer-to-Peer Request Line Launches July 12, 2025
Health Net·CA·Prior Authorization
Effective date
Jul 12, 2025
We identified it
Jun 20, 2026
Summary
Health Net is launching a new dedicated peer-to-peer review request line (833-236-9715) on July 12, 2025, with streamlined scheduling and live answer during business hours. The policy clarifies required information and timing restrictions for peer-to-peer requests, including the 5-business-day deadline after adverse determinations.
Action Required
By July 12, 2025: Update all staff contact information and procedures to use the new peer-to-peer review line 833-236-9715. Train billing and clinical staff on the required information list (member name, DOB, case number, medical director name, nurse name, member ID) and timing restrictions (5 business days for adverse determinations, prior to discharge for concurrent reviews). Update internal documentation and quick reference guides with the new phone number.