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Become a Provider

Thank you for your interest in obtaining an agreement for participation in the Health Net Health Plan of Oregon provider network.

The lists below will assist you in determining which application applies to you or your organization. Specific instructions on submission are included within each application.

During the application and contracting process, claims payment will be subject to the member’s plan benefit. Network participation will be confirmed by Health Net Health Plan of Oregon.

How Health Net Can Help You

Let us help you keep your practice in tip-top shape. Use the provider portal for the following:

  • Create multiple user accounts for your staff members.
  • Control permission settings for each staff member's account.
  • Keep track of payments.
  • Convenient 24/7 access to the forms you need most.

To request participation in the Health Net network

  1. Identify your specialty (Practitioner or Organizational). The lists below will assist you in determining which application applies to you or your organization. Specific instructions on submission are included within each application. Do not submit both forms.
  2. Download and complete the correct participation form.
  3. Return your completed form to the location indicated on the form.

During the application and contracting process, claims payment will be subject to the member’s plan benefit. Network participation will be confirmed by Health Net Health Plan of Oregon. 


Identify Your Specialty

Oregon/Washington Physicians

Physician Network Participation Request Form (pdf)

To be completed for the following provider types:

  • Primary Care Physicians (PCPs):
    • Internal Medicine
    • Family Practitioners
    • OB/GYNs
    • Pediatricians
  • Specialists:
    • ENT
    • Orthopedic Surgeon
    • Surgery
  • Allied health professionals:
    • PT, OT, Speech Therapist
    • Midwife
    • Dietitian, Nutritionist
    • Physician Assistant

Oregon/Washington Ancillary Providers

Ancillary Provider Network Participation Request Form (pdf)

To be completed for the following provider types:

  • Ambulatory surgery centers (ASCs)
  • Dialysis facilities
  • Durable medical equipment (DME)
  • Home health
  • Home Infusion
  • Hospice
  • Laboratory
  • Long term acute care (LCTA)
  • Orthotics and prosthetics (O&P)
  • Ostomy and medical supplies
  • Radiology/MRI/PET
  • Skilled nursing facilities (SNF)
  • Sleep study centers

Other Providers 

(Do not submit any of the above forms.)

  • Behavioral Health:
    Unless an employer group utilizes another behavioral plan, MHN manages behavioral health and substance abuse benefits for Health Net members. 1-800-977-8216
  • Retail Pharmacies: 
    Contact CVS Caremark® at (480) 314-8457
  • Vision Providers: 
    Contact EyeMed Vision Care online at www.eyemedvisioncare.com
    1-866-392-6058
  • Dental Providers: 
    Contact Dental Benefit Providers (DBP) 1-877-410-0176
  • Alternate Care: 
    Contact American Specialty Health 1-800-678-9133
  • Hospitals:
    Hospitals that would like to participate in Health Net's Provider Network may call the following number: 1-888-802-7001