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Medicare AdvantageAdministrativeMedium impact

24-1052 Provider Communications Posted Online and Operations Manual Updates for September 2024

Health Net·CA·Prior Authorization
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net California posted September 2024 provider communications and operations manual updates covering multiple topics including telehealth billing requirements, vaccine administration changes, and balance billing prohibitions for Medi-Cal members.

Action Required

Action needed
Review September 2024 communications at Health Net's Provider Library. Key actions: 1) Update demographic information via Symphony portal as required, 2) Ensure compliance with Medi-Cal balance billing prohibitions, 3) Review telehealth billing requirements for appropriate CPT and HCPCS code usage, 4) Note that ACIP-recommended vaccines can now be billed under medical benefits without prior authorization (retroactive to 1/1/23).