MedicaidAdministrativeMedium impact
24-941m How to Make Sure Your Claims Aren't Rejected
Health Net·CA·Reimbursement
We identified it
Jun 20, 2026
Summary
Health Net/CalViva Health has updated their claims submission requirements, emphasizing EDI submission through Availity and Ability clearinghouses with specific payer IDs (68069 and 95567). For paper claims, strict formatting requirements are enforced including Times New Roman font, original red and white forms (Flint OCR Red J6983), and prohibition of photocopies.
Action Required
Immediately: Billing team must update EDI systems to use correct payer IDs (Availity: 68069, Ability: 95567) for CalViva Health claims. For any paper claims, ensure use of original CMS-1500 or UB-04 forms in Flint OCR Red J6983 ink only, typed in 10-12 point Times New Roman font. Contact 800-225-2573 ext. 6075525 for EDI setup assistance if needed.