MedicaidAdministrativeMedium impact
21-529 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
HealthNet California requires providers to verify that Medi-Cal is the payer of last resort before billing to avoid post-payment collections. Providers must use enhanced eligibility reports to check for other health coverage information before submitting Medi-Cal claims.
Action Required
Immediately: Billing team must verify other health coverage using HealthNet's enhanced eligibility report (PDF) before submitting Medi-Cal claims. Ensure all other insurance is billed first before billing Medi-Cal as secondary payer. This applies to members in Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties to avoid post-payment collection issues.