MedicaidAdministrativeHigh impact
24-1337 Annual Review and Updates to the Medi-Cal Provider Operations Manual
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health has updated their comprehensive Medi-Cal Provider Operations Manual affecting multiple sections including prior authorizations, claims processing, coding policies, and billing procedures. This annual review updates requirements for Medi-Cal providers in Fresno, Kings, and Madera counties.
Action Required
Immediately: Billing team must review the updated Medi-Cal Provider Operations Manual at the CalViva Health provider portal to identify specific changes to prior authorization requirements, coding policies, claims processing, and billing procedures. Contact CalViva Health at 888-893-1569 for clarification on any updated requirements. Update internal workflows and billing system configurations based on the revised manual sections.