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Network: HPN Leaving SmartCare and Service Area Changes

Sep 16, 2014

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:

ZIP City
92201 Indio
92202 Indio
92203 Indio
92210 Indian Wells
92211 Palm Desert
92234 Cathedral City
92235 Cathedral City
92236 Coachella
92240 Desert Hot Springs
92241 Desert Hot Springs
92247 La Quinta
92248 La Quinta
92253 La Quinta
92254 Mecca
92255 Palm Desert
92258 North Palm Springs
92260 Palm Desert
92261 Palm Desert
92262 Palm Springs
92263 Palm Springs
92264 Palm Springs
92270 Rancho Mirage
92274 Thermal
92276 Thousand Palms

HPN PPGs in SmartCare Network to be removed:

PPG # PPG name County
533 Affiliated Doctors of Orange County Orange
2837 Community Medical Group-Agoura Los Angeles
2909 Community Medical Group-IPA Physicians Los Angeles
2835 Community Medical Group-Simi Valley Los Angeles
2836 Community Medical Group-Thousand Oaks Los Angeles
2834 Community Medical Group-West Hills Los Angeles
644 Desert Oasis Healthcare Riverside
690 Eastland Medical Group Los Angeles
3145 Eastland Medical Group-Glendale Los Angeles
3073 Eastland Medical Group-Glendora Division Los Angeles
3201 Greater Covina-Regal Medical Group Los Angeles
0P2 Heritage Health Care Los Angeles
2731 Heritage Provider Network Los Angeles
2743 Heritage Victor Valley Medical Group San Bernardino
032 High Desert Medical Group Los Angeles
3109 Lakeside Medical Group-Burbank/North Hollywood Los Angeles
3112 Lakeside Medical Group-Central Valley Los Angeles
2943 Lakeside Medical Group-Glendale Los Angeles
3111 Lakeside Medical Group-North Valley Los Angeles
3110 Lakeside Medical Group-Santa Clarita Los Angeles
2945 Lakeside Medical Group-Verdugo Los Angeles
3388 Regal Medical Group-Glendale Physicians Alliance Los Angeles
3153 Regal Medical Group of Orange County Los Angeles
3506 Regal Medical Group of Riverside County San Bernardino
3158 Regal Medical Group of San Bernardino County San Bernardino
2781 Regal Medical Group of Los Angeles Los Angeles
2902 Regal Medical Group of San Fernando Valley Los Angeles
25 San Gabriel Valley Regal Medical Group Los Angeles
3383 Sierra Medical Group Los Angeles
80 West Covina Medical Clinic, Inc. Los Angeles

Employer and member communications

Health Net will send the following communications to affected members and employers regarding these changes as outlined below:

SmartCare Brok​er 90​-day Letter

SmartCare E​mployer 9​0-day Letter

SmartCare Memb​er 90-d​ay Letter

SmartCare Member Letter Noncrosso​ver 60-day Letter

SmartCare Mem​ber Letter Crossover 60-day Letter

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.

Have questions?

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.

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