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  • Ancillary Provider Network Participation Request Form - Health Net

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CALIFORNIA ANCILLARY PROVIDER NETWORK PARTICIPATION REQUEST FORM Health Net of California Instructions to Ancillary Provider: ? ? ? ? This form allows ancillary providers to request participation.

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Timely Filing of Claims When Health Net is the secondary payer, we will process claims received within 180 days after the later of the date of service and the date of the physician's receipt of an Explanation of Benefits (EOB) from the primary payer.

California Customer Service Health Net Medi-Cal1-800-675-6110CalViva1-888-893-1569TTY (hearing and speech impaired)711

Contact Member Services toll free at 1-800-675-6110 (TTY: 711), 24 hours a day, 7 days a week.

Enrolled through Covered California (HMO) Complete, Green, Gold Select, Healthy Heart, Ruby, Ruby Select1-800-275-4737(HMO SNP) Amber I, Amber II, Amber II Premier, Jade1-800-431-9007(PPO) Violet1-800-960-4638Sales and Enrollment1-800-949-3022, option 3TTY (hearing and speech impaired)7111 more row

1-800-641-7761 Verification of eligibility, benefits and claims. Note: All phone hours are Pacific standard time. CA89403 (7/12) Health Net of California, Inc.

We are here to answer any questions you have about your Health Net plan. Many of your questions can also be answered when you log in to your account online....I am a Member. ContactPhone NumberCustomer Service1-888-802-7001, option 1TTY (hearing and speech impaired)1-888-802-7122

Contact Member Services toll free at 1-800-675-6110 (TTY: 711), 24 hours a day, 7 days a week.

Contact Health Net Provider Services Center Online Provider ServiceContact NumberHealth Net Provider Services Center (Except Medi-Cal and Medicare)1-800-641-7761Provider Services Medi-Cal1-800-675-6110 1-800-281-2999 (fax)Provider Services Cal MediConnect: Los Angeles County San Diego County1-855-464-3571 1-855-464-35726 more rows • 2 Mar 2023

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232