CommercialAdministrativeMedium impact
24-943m How to Make Sure Your Claims Aren't Rejected
Health Net·CA·Reimbursement
We identified it
Jun 20, 2026
Summary
Health Net has updated claim submission guidelines to prevent rejections, emphasizing EDI submission through Availity and Ability clearinghouses, and specifying strict formatting requirements for paper claims including mandatory use of Flint OCR Red ink and proper CMS forms.
Action Required
Immediately: Billing team should transition to EDI submission through Availity (Payer ID 68069) or Ability (Payer ID 95567) clearinghouses for improved efficiency. For any remaining paper claims, ensure use of proper CMS-1500 or CMS-1450 forms printed in Flint OCR Red ink (J6983) in 10-12 point Times New Roman font. Contact Health Net at 800-225-2573 ext. 6075525 for EDI setup assistance. Failure to follow formatting guidelines will result in claim rejections.