Claims

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Health Net Claims Process


SEEKING REIMBURSEMENT?

In the event, you needed to seek medical care before you received your insurance ID cards from as an enrolled Health Net member, you will be able to file a claim if you paid out-of-pocket for the medical services rendered.   

If approved, your claim will only reimburse the amount that Health Net would have covered as the benefit. 
To submit a claim: 

  1. Complete one of the claim forms below: ·        
    1. PRESCRIPTION CLAIM FORM 
    2. MEDICAL CLAIM FORM 
    3. VISION OUT-OF-STATE CLAIM FORM
    4. DENTAL HMO CLAIM FORM 
    5. FOREIGN CLAIM QNR 
  2. Obtain a copy of an itemized bill that includes diagnosis codes 
  3. Copy of the receipt, showing the amount you paid
  4. Complete the HIPPA form ·       
    1. HIPAA FORM 
  5. Mail all the documents to the address listed on the claim form.   

MHN Commercial Claim Form

EXPLANATION OF BENEFITS DOCUMENT

After you use your Health Net benefits, you may receive a document called an Explanation of Benefits, also known as the EOB. This document is not a bill, but a detailed description of the services you received and the relative cost. To view a descriptive sample that can assist you in understanding this document, please click below:

UNDERSTANDING YOUR EOB 


MOBILE APPS

You can access your health plan information (such as ID cards, copays, deductible info, etc) with Health Net by using their mobile friendly site. Click below for further details or visit www.healthnet.com/mobile:

HEALTH NET MOBILE 

 

 

HEALTHNET CUSTOMER SERVICE

If you have questions relating to your EOB or to a recent claim that was submitted to Health Net, please call the Health Net customer service department at 1-800-522-0088.


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