Provider Email Address Collection

Seeking Email Addresses

In an effort to improve the quality, relevance, and timeliness of provider communications, Health Net has moved from fax and hard copy notifications to email. Please complete the form below. You may submit as many contacts as are appropriate for your practice. 

Thank you for helping us to be more nimble and responsive to our providers’ needs.

Provider Type required*
Line of Business (Check all that apply) required*
Do you also accept Trillium OHP/Medicaid? *