CommercialPrior AuthHigh impact
22-682 Nonparticipating Hospital Post-Stabilization Notification
Health Net·CA · Emergency Medicine, Critical Care·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net requires nonparticipating hospitals to obtain prior authorization for post-stabilization care by calling 800-995-7890, option 1, for all HMO, POS, HSP and Medi-Cal patients. However, due to COVID-19, prior authorization requirements are temporarily suspended - hospitals should fax admission notifications to 800-676-7969 instead.
Action Required
Immediately: Hospital billing teams must use the temporary COVID-19 process - fax all inpatient admission notifications to 800-676-7969 instead of calling for prior authorization. For urgent authorization status, call Provider Services: Employer Group HMO/POS/HSP/EPO (800-641-7761), Individual Plans (888-926-2164), Medi-Cal (800-675-6110), or Coventry (800-937-6824). For CCS-eligible members under 21, still call 800-995-7890 option 1 then fax SAR to local CCS office. Failure to follow notification requirements may result in claim denials.