CommercialAdministrativeLow impact
21-537 Commercial Capitation Eligibility Report Changes
Health Net·CA·Provider News
Effective date
Oct 1, 2021
We identified it
Jun 20, 2026
Summary
Health Net is adding new fields for other health coverage (OHC) information to the commercial Eligibility Report (BRM 42) for capitated/delegated participating physician groups and hospitals. The file size is increasing from 400 bytes to 512 bytes to accommodate these changes.
Action Required
No immediate action required for billing team. This is a system change to Health Net's eligibility reporting that does not affect billing processes. PPGs and hospitals using the BRM 42 report should be aware that file layouts have changed and can access updated layouts through Provider Reports > Data File Record Layouts in the Health Net provider portal.