Submission of Clinical Information

Health Net of California does not routinely require or request clinical information at the time of claim submission.

Health Net of California does reserve the right to request clinical records before or after claim payment to identify possible fraudulent or abusive billing practices, as well as any other inappropriate billing practice not consistent or compliant with AMA CPT codes or guidelines, provided there is ample evidence such an investigation is warranted.

Health Net of California, Inc.’s Medi-Cal State Health Programs does not routinely require or request clinical information at the time of claim submission.

Health Net of California, Inc.’s Medi-Cal State Health Programs reserves the right to request clinical records before or after claim payment to identify possible fraudulent or abusive billing practices, as well as any other inappropriate billing practice not consistent or compliant with the AMA CPT codes or guidelines, provided there is evidence such an investigation is warranted