MedicaidAdministrativeHigh impact
20-626 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 to reconcile and submit missing Medi-Cal claims and encounters for the July-December 2019 service period by November 10, 2020, to ensure eligibility for supplemental payment programs. Hospitals must review Excel reconciliation files, correct rejected claims, and submit any missing fee-for-service claims or capitated encounters through standard processes.
Action Required
By November 10, 2020: Hospital billing teams must review Health Net's Excel reconciliation files via secure email, correct and resubmit any rejected claims/encounters through standard claims processing, submit missing fee-for-service claims to Health Net, contact capitated provider groups to submit missing encounters, and return completed Excel files to Health Net. Failure to submit by deadline may result in missing the final DHCS deadline and losing supplemental payment eligibility.