MedicaidAdministrativeMedium impact
22-303m How to Help Your Paper Facility Claims Process Faster
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net updated paper facility claim filing requirements for UB-04 forms, including specific box completion rules for inpatient vs outpatient claims. Extended COVID-19 claim filing deadlines expire January 1, 2022, returning to standard timelines, and confirms balance billing prohibition for COVID-19 screening/testing.
Action Required
Immediately: Billing team must update UB-04 form completion procedures - left align provider information in Box 1, complete boxes 12-15 and 17 for inpatient claims (plus box 16 for post-discharge), complete only boxes 14, 15, and 17 for outpatient claims, except for bill types 012x, 022x, 032x, 034x, 081x, and 082x which require boxes 12 and 13. Ensure no balance billing occurs for COVID-19 screening/testing services.