MedicaidDocumentationMedium impact
21-038-send-birth-event-clinical-records-when-requested
Health Net·CA · OB-GYN, Pediatrics·Provider News
We identified it
Jun 20, 2026
Summary
Health Net now requires hospitals and ancillary providers to submit specific newborn clinical information (name, birth details, APGAR scores, birth status) within one business day when requested by Case Management after delivery notifications. This applies to Medi-Cal members in specific California counties.
Action Required
Immediately: Hospital billing teams must establish workflow to respond to Health Net Case Management requests for newborn clinical records within one business day via fax at 1-855-556-7909. Create standardized form capturing: newborn's name, birth date/time, birth order, delivery type, age, gender, weight, APGAR scores (1 and 5 minute), and birth status. Train staff to contact 1-866-801-6294 option 2 for questions about request forms.