Effective January 1, 2024, Administration of Behavioral Health Services Will Transition to Health Net and Wellcare By Health Net
Beginning in January 2024, behavioral health services will no longer be administered by MHN, Health Net's behavioral health administrator. Instead, these services will be arranged by Health Net and Wellcare By Health Net. Members will not experience any changes to their behavioral health benefits as a result of this change.
Operational and administrative plan changes
Certain functions, such as eligibility and benefit checks, claims submission, referrals, prior authorizations, provider portal and websites, and more may be affected. Refer to the chart below for important details prior to and after January 1, 2024.
| Functions | Prior to January 1, 2024 | After January 1, 2024 |
|---|---|---|
| Claim submission For claims with overlapping dates of service (DOS), providers are advised to split the claim for end of year services. Submit 2 different claims. | MHN Claims P.O. Box 14621 Lexington, KY 40512-4621 Payer ID: 22771 Phone: 800-444-4281 Fax: 877-719-4804 | Medicare Claims: Health Net Medicare Claims PO Box 9030 Farmington, MO 63640-9030 Payer ID: 68069 Commercial Claims: Health Net Commercial Claims PO Box 9040 Farmington, MO 63640-9040 Payer ID: 95567 |
| Eligibility and benefit checks | MHN website | Health Net Oregon Provider Portal |
| Provider Services | Phone: 844-966-0298 | Medicare Phone: 888-445-8913 Option 2 Commercial Phone: 888-802-7001 Option 2 |
| Provider Engagement/Relations | Email: OR.Prov.Reps@healthnet.com | |
| Provider portal/website | MHN website | Secure portal: Health Net Oregon Provider Portal Public website: Health Net Oregon website |
| Referral | Contact the MHN Customer Service Department for a referral to an MHN provider. Phone: 888-935-5966 | Contact the Health Net Customer Service Department for a referral to a BH provider. Medicare Phone: 888-445-8913 Commercial Phone: 888-802-7001 |
| Prior Authorization | Authorized by MHN Phone: 888-935-5966 | Authorized by Health Net Medicare Phone: 800-672-5941 Commercial Phone: 888-802-7001 |
| Provider Dispute Resolution | MHN Appeals & Grievances P.O. Box 10697 San Rafael CA 94912 | Behavioral Health Provider Dispute Resolution Request Form (PDF) Commercial Claim: Mail Claim Dispute form and attachments to: Commercial Claim Disputes PO Box 9040 Farmington, MO 63640-9030 Medicare Claim: Mail Claim Dispute form and attachments to: Medicare Claim Disputes PO Box 9030 Farmington, MO 63640-9030 Appeals based on medical necessity: Health Net Appeals & Grievances Medicare Operations P.O. Box 10450 Van Nuys, CA 91410-0450 Appeals not based on medical necessity: Health Net Medicare Operations 7700 Forsyth Blvd St. Louis, MO 63105 |
| Provider Operations Manual | MHN website | Health Net Oregon website |