CommercialAdministrativeLow impact
22-159m Verify Member Eligibility with IVR Self-Service Tool
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net has updated their IVR (Interactive Voice Response) self-service tool for verifying member eligibility. Providers can now call Provider Services and use the automated system to quickly check member eligibility status, benefits, and claim status without waiting on hold by entering their NPI, TIN, and member information.
Action Required
Immediately: Train front desk staff and billing team on the new IVR system process. Update eligibility verification procedures to include the option of calling Provider Services and using the automated system (enter NPI, TIN, member ID, DOB, and zip code, then select option 3). Continue using the Health Net provider portal as the primary method for real-time eligibility verification.