CommercialPrior AuthMedium impact
21-278 Nonpar Hospital ER Admit Post-Stabilization
Health Net·CA · Emergency Medicine·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net requires nonparticipating hospitals to call 800-995-7890, option 1 to obtain prior authorization for post-stabilization care after emergency treatment for Health Net HMO, POS, and HSP members. However, this requirement is currently suspended due to COVID-19, and hospitals should instead fax admission notifications to 800-676-7969.
Action Required
Immediately: For Health Net members at nonparticipating hospitals, fax inpatient admission notifications to 800-676-7969 instead of calling for prior authorization (COVID-19 suspension). Update billing team procedures to ensure timely notification is sent to avoid claim denials. For CCS-eligible members under 21, still call 800-995-7890 option 1 then fax SAR to local CCS office. Monitor for notification when normal prior auth requirements resume.