MedicaidAdministrativeMedium impact
21-530 Avoid Post-Payment Collection: Make Sure Medi-Cal is the Payer of Last Resort
Health Net·CA·Reimbursement
Effective date
Jul 23, 2021
We identified it
Jun 20, 2026
Summary
Health Net California reminds providers in Fresno, Kings, and Madera counties to verify other health coverage before billing Medi-Cal to ensure Medi-Cal is the payer of last resort and avoid post-payment collections. Providers should use the enhanced eligibility report to check for other health coverage information.
Action Required
Immediately: Billing team must verify other health coverage (OHC) using Health Net's enhanced eligibility report before submitting Medi-Cal claims for patients in Fresno, Kings, and Madera counties. Update workflow to check for primary insurance coverage first to ensure Medi-Cal bills as secondary payer only. Failure to verify could result in post-payment collections.