MedicaidAdministrativeMedium impact
24-239 Is the Member with Health Net or Assigned to Molina? Verify Eligibility Through the Health Net Provider Portal
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net has issued guidance to ensure providers submit claims and prior authorization requests to the correct health plan when members may be confused between Health Net and Molina coverage. Providers must verify member eligibility through the Health Net Provider Portal before submitting requests.
Action Required
Immediately: All staff must verify member eligibility through the Health Net Provider Portal before submitting any claims or prior authorization requests for members who may have Health Net or Molina coverage. Download and review the Provider Update PDF from Health Net. Billing team should establish a workflow to double-check member eligibility for Los Angeles and Molina counties Medi-Cal members to prevent submission to wrong payer.