MedicaidPrior AuthMedium impact
25-424 Provider Communications Posted Online and Operations Manual Updates for April 2025
Health Net·CA·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net has updated their Medi-Cal provider operations manual with changes to prior authorization processes, contact information, and added new CalAIM services documentation. Key updates include clarified prior authorization procedures and contact details for submitting requests.
Action Required
Immediately: Update prior authorization contact information and submission procedures per the revised 'Requesting Prior Authorization or Coordinating a PCP Referral' documentation. Billing team should verify current phone, fax, and online submission contact details are updated in workflow processes. Review new Enhanced Care Management (ECM) and Community Supports documentation for potential billing opportunities.