MedicaidAdministrativeHigh impact
20-203 Submit Data by May 15, 2020, for Supplemental Payment
Health Net·CA·Prior Authorization
Effective date
May 15, 2020
We identified it
Jun 20, 2026
Summary
Health Net is requiring hospitals in Fresno, Kings and Madera counties to reconcile Medi-Cal claims and encounters from January-June 2019 and submit any missing or corrected data by May 15, 2020, to qualify for supplemental payments through the DPH-EPP and PHDP programs.
Action Required
By May 15, 2020: Hospital billing teams must review the Excel reconciliation file from Health Net, identify missing fee-for-service claims not included in the file, and resubmit any rejected or corrected claims through standard processing. Contact capitated provider groups immediately to ensure they submit missing encounters to Health Net before the deadline. Failure to meet the May 15 deadline may result in missing the final DHCS submission date and losing supplemental payment eligibility.