Resources
Rainbow Guide
Email Provider Relations at hn_provider_relations@healthnet.com to request your printed toolkit filled with key operational and preventative services information.
Download ToolkitOperations Guide
Download this Operations Guide
for basic information about public
health programs available to CalViva Health patients, use of and access to Medi-Cal services, physician responsibilities for
coordination of patient care, and provision of health services.
CalAIM Resources for Providers
For Help in supporting your Medi-Cal patients under the CalAIM program click here.
Prior Authorization List
Download this Prior Authorization List
Providers should refer to the member’s Evidence of Coverage (EOC) to determine exclusions, limitations and benefit maximums that may apply to a particular procedure, medication, service, or supply.
Prior Authorization Requirements Report and Metrics Summary
In accordance with the Centers for Medicare & Medicaid Services (CMS) Final Rule (CMS‑0057‑F), we are annually publishing our prior authorization requirements and performance metrics to promote transparency, accountability, and better support our members and providers.
- CMS Final Rule 0057-F Prior Authorization Requirements for CY2025
- Prior Authorization Metrics Summary
The data presented in these publications reflects prior authorization requests processed during the applicable measurement year in accordance with CMS reporting specifications. Metrics are calculated using CMS‑defined methodologies and may not be directly comparable to alternative reports or third‑party summaries.
Continuity of Care Policy
Download this Continuity of Care Policy
Download this Continuity of Care Policy (Spanish)
Download this Continuity of Care Policy (Hmong)
to give to patients who would like to request continuation of care upon a change in the status of their health plan.
Contract Drug List (CDL)
View the Contract Drug List (CDL) on the DHCS website
for the Medi-Cal CDL that is maintained by the Department of Healthcare Services (DHCS).
Medi-Cal 101 Brochure
Download this Medi-Cal 101 Brochure
Download this Medi-Cal 101 Brochure (Spanish)
Download this Medi-Cal 101 Brochure (Hmong)
to give to patients who would like to learn about Medi-Cal and if they are able to get it. Use this brochure to help answer some of their questions about Medi-Cal and what it has to offer.
Provider Notification of Pregnancy Form
Download this Notification of Pregnancy Form
to best utilize CalViva Health resources and services to help you and your patient achieve a health pregnancy outcome.
