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MedicaidPrior AuthMedium impact

24-676 Provider Communications Posted Online and Operations Manual Updates for June 2024

Health Net·CA · Radiology, OB-GYN, Cardiology·Prior Authorization
Effective date
Jun 12, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net California published their June 2024 provider communications summary, including updates to prior authorization processes, medical policies, and operational manual changes. Key changes include updated Advanced and Cardiac Imaging prior authorization contacts (NIA changed to Evolent Specialty Services) and enhanced pregnancy screening coverage for sex chromosome aneuploidy.

Action Required

Action needed
Immediately: Update prior authorization submission processes for Advanced and Cardiac Imaging - replace National Imaging Associates, Inc. (NIA) contact information with Evolent Specialty Services, Inc. (Evolent) for all HMO and PPO plans. Billing team should verify current contact details in provider portal and update any saved forms or workflows that reference NIA.