MedicaidAdministrativeHigh impact
26-923 Prepare for 2026 Provider Access Surveys
Health Net·CA·Prior Authorization
Effective date
Aug 1, 2026
We identified it
Aug 1, 2026
Summary
HealthNet California will conduct mandatory provider access surveys from August–December 2026 to assess appointment availability, after-hours access, and phone accessibility. Providers must respond within 5 business days of survey requests from Sutherland or face claim payment delays, directory removal, and corrective action plans. This is a compliance requirement under California law and provider contracts.
Action Required
REQUIREMENTS:
Before August 2026 survey outreach begins:
- Front desk/clinical staff: Verify that appointment availability, after-hours access, and phone access standards are currently being met and documented.
- IT/Operations staff: Test all office phone systems and after-hours messaging to confirm instructions are accurate and voicemail systems function properly. Identify any gaps in urgent vs. non-urgent care access.
- Administrative/Billing staff: Ensure provider directory information and all contact information (email, fax, phone) in HealthNet's system is current and accurate so survey invitations from Sutherland reach the office.
- Providers/PCPs: Review eligibility for the Qualified Advanced Access Provider Program if offering same-day scheduling—contact DMHC Access for enrollment to receive 3-year compliance exemption.
Upon receipt of survey invitation from Sutherland (begins August 2026):
- Designated staff member: Complete and submit the online survey within 5 business days of receipt. Include information on telehealth appointment availability, urgent care wait times (including weekends/holidays), and alternative access methods.
- Billing team: Monitor for any survey non-compliance flags in claims processing. Non-response or failure to meet access standards will result in: (1) claim payment delays, (2) removal from HealthNet provider directory, (3) corrective action plans, and (4) impacts to network participation.
ONGOING:
- Maintain accurate contact information throughout 2026 survey cycle (August–December).
- Contact Sutherland at 585-498-7498 or email Sutherland PAAS Team with survey questions. Contact DMHC Access for access standard requirement questions.