Submit claims

Submit claims through a clearinghouse: Get Started

For successful EDI claim submission, you will need to use electronic reporting made available by your vendor and/or clearinghouse. Health Net returns claims acknowledgements to the clearinghouse with notifications of acceptance or rejection of individual claims. Providers can review these reports to check the status of their submission.

Health Net processes anesthesia, medical, coordination of benefits (COB), hospital, and surgical claims electronically. We accept electronic claims directly from Availity and Ability. Claims regarding other benefits, including certain mental health, complementary treatments, pharmacy, and outpatient radiology are administered for Health Net by outside vendors and claims are processed by each vendor accordingly.

Health Net partnership with MD On-line/Ability allows even the smallest practice to take advantage of EDI savings, for free. Using this web-based solution, you can submit direct to Health Net on-line.

Submitting claims to Health Net through Availity

Health Net has contracted with Availity to provide claims clearinghouse services for Health Net claim submission. Availity will work with your clearinghouse or vendor to get the claims submitted to Health Net in a timely manner.

Reports

Providers may also check the status of paper and electronic claims via Health Net claims status transaction available through Availity or online at HealthNet.com. Registration is required.

To learn more about EDI and become a certifiedĀ EDI Professional, please visit ourĀ course schedule page.

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