News & Updates
Effective December 1, 2014, Heritage Provider Network (HPN) leaving SmartCare & Service Area Changes
As with many of the coming changes, Health Net wants you to have the timely and relevant information you need to support your clients.
What you need to know
Heritage Provider Network (HPN) and its affiliated PPGs will be removed from the SmartCare network (pending regulatory approval). This change affects all SmartCare plans including ACA-compliant and transitional relief (grandmothered) plans.
As a result, Health Net SmartCare is withdrawing from 24 ZIP codes within Riverside County (see chart below). This withdrawal does not affect any of Health Net's other tailored networks, such as ExcelCare, or WholeCare
Timing and member access
HPN will be removed from the SmartCare Network for new and renewing groups, on or after December 1, 2014, for new and renewing groups. Existing members whose group renews prior to 12/1 will be able to access HPN PPGs until their group’s next renewal in 2015. Members whose group renews on or after 12/1 will be required to select another SmartCare PPG or product.
HPN providers exiting from the SmartCare Network
These ZIP codes will be removed from the SmartCare service area for groups sold or renewed on or after December 1, 2014.
Affected Riverside ZIP codes:
|92240||Desert Hot Springs|
|92241||Desert Hot Springs|
|92258||North Palm Springs|
HPN PPGs in SmartCare Network to be removed:
Employer and member communications
Health Net will send the following communications to affected members and employers regarding these changes as outlined below:
Transition of care
Impacted SmartCare Network members will receive a Transition of Care (TOC) form with their PPG change letters (PCP crossover/non-crossover). Members who meet the criteria for TOC are encouraged to fill out the TOC form and either mail or fax the letter to Health Net’s Medical Management Department. Standard rules of TOC apply.
If you have questions or need more information about this change to the SmartCare Network, please contact a member of your b&p Sales Team - 888.722.3373.