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MedicaidAdministrativeLow impact

24-168m Ask Members to Complete the Health Information Form So They Get Needed Services

Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health requires newly enrolled Medi-Cal members to complete a Health Information Form within 90 days of enrollment. Primary care physicians must remind patients during their required Initial Health Appointment (within first 120 days) to complete this form to help identify health barriers and additional service needs.

Action Required

Action needed
Front desk and providers should remind newly enrolled CalViva Health Medi-Cal patients during Initial Health Appointments (required within first 120 days of enrollment) to complete the Health Information Form within 90 days. The form is available in their welcome booklet or can be completed via the member portal. No billing impact - this is for care coordination and member services only.
24-168m Ask Members to Complete the Health Information Form So They Get Needed Services | Health Net | PolicyChanges.app