Thank you for your interest in participating with Health Net. We are excited that you have selected our provider network as your network of choice. Please select the Network Participation Request Form listed below based on your specialty and services you provide. Please return this completed form, along with your W9, to our email address: NewProviderRequestBox@Healthnet.com (Please note: these forms do not replace the credentialing forms/ requirements for our contractual agreements and requirements)
Important note regarding Health Net's Provider Network:
We are committed to maintaining a behavioral health provider network that ensures our members have timely access to culturally responsive, high-quality care in the most appropriate clinical settings. At this time, our routine outpatient behavioral health network is generally meeting member needs across our lines of business. As a result, we are not routinely extending new contracts for outpatient behavioral health services and are unable to move forward with new applications at this time unless the request addresses a clearly identified unmet need.
Applications from providers certified by the Oregon Health Authority (OHA) in Culturally and Linguistically Specific Services (CLSS) continue to be reviewed on an individual basis.
Please note that Laboratory and Durable Medical Equipment (DME) providers are contracted at the Centene National Contracting level. Providers seeking participation for these services must be contracted through the national program in order to be considered. To initiate this process, providers may contact the National Contracting team directly at NationalContracting_RosterSubmission@CENTENE.COM.
We regularly monitor access, utilization, and network capacity and may revisit contracting as specific needs are identified.
Network Participation Request Forms:
Physician Network Participation Request Form (PDF)
- All Medical Specialties
- Solo Practitioners
- Allied health professionals such as:
- Midwife
- Dietitian, Nutritionist
- Physician Assistant
- Medical Groups
- Multi-Specialty Medical Groups
Facilities
Credentialing Requirements/Forms, for new facility enrollment:
* Please send all documents and/or roster to NewProviderRequestBox@healthnet.com
Ancillary Network Participation Request Forms:
Ancillary Network Participation Request Form (PDF)
- 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
Network Requests Managed by External Contractors
- Behavioral Health:
Through December 31, 2023: - Unless an employer group utilizes another behavioral plan, Health Net Behavioral Health manages behavioral health and substance abuse benefits for Health Net members.
- Contact Health Net Behavioral Health directly or call 1-800-977-8216 to request participation in the network.
- Note: Please visit our Behavioral Health Services Transition webpage for information about Behavioral Health Services administration effective January 1, 2024.
- Alternative Care Specialties such as Chiropractic, Naturopathic, Acupuncture (Statewide)
Contact ASH Network (American Specialty Healthcare) at 1-800-678-9133 or visit the ASH Network website - Retail Pharmacies:
Contact CVS Caremark® at 480-314-8457 - Vision Providers:
Contact EyeMed Vision Care online by visiting the EyeMed Vision website or call 1-866-392-6058 - Dental Providers:
Contact Dental Benefit Providers (DBP) at 1-877-410-0176
Network Participation Next Steps
Once you have a completed Network Participation form, please email all of the documents to the email address listed above. Someone from our contracting department will review your request for network addition/participation. A representative will be in contact with you with regarding status of this review. (Please note: If you receive a contract, there will be additional credentialing documents required to finish the contracting process.)
