MedicaidAdministrativeMedium impact
20-694 Submit Contract Status Validation for Hospital Directed Payment Programs
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net requires participating hospitals and physician groups in Fresno, Kings, and Madera counties to validate contract status for Medi-Cal directed payment programs by completing and returning encounter files with specific contract status codes.
Action Required
By December 28, 2020: Hospitals and capitated providers must complete contract status validation files received from Health Net, adding appropriate status codes (C-Contracted, H-Hospital to hospital, N-Not contracted) in designated columns. Use correct file naming convention and email completed files to both Dianna.Bailey@Centene.com and HNCA_DirectPay@HealthNet.com. By March 5, 2021: Submit second/final pass files. Do not modify file structure or data - files with changes will be rejected.