MedicaidAdministrativeHigh impact
20-627 Submit Data by November 10, 2020, for Supplemental Payment
Health Net·CA·Prior Authorization
Effective date
Nov 10, 2020
We identified it
Jun 20, 2026
Summary
Health Net is requiring hospitals in Fresno, Kings, and Madera counties to reconcile and submit missing Medi-Cal claims and encounters from July-December 2019 by November 10, 2020, for supplemental payment programs. Hospitals must review Excel reconciliation files and resubmit any missing or corrected data through standard claims processing.
Action Required
By November 10, 2020: Hospitals in Fresno, Kings, and Madera counties must review Excel reconciliation files from Health Net via secure email, identify missing fee-for-service claims and capitated encounters not listed, resubmit corrected claims through standard processing, and return completed Excel files. Contact capitated provider groups immediately to ensure encounter submission. Claims received after November 10, 2020 may not meet the December 31, 2020 DHCS deadline for supplemental payments.