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Provider Digest | Volume 201

Date: 01/28/26

Health Net Commercial Providers: Enroll in Electronic Payments with Zelis® 

We’re excited to announce a new partnership between Health Net and Zelis, effective April 1, 2026, to enhance and streamline your electronic claims payment experience.

Effective immediately, you are strongly encouraged to select an electronic claim payment method through Zelis or the Health Net ePayment Center to continue receiving claim payments electronically issued on or after April 1, 2026. This change will help reduce the administrative burden, improve payment speed, and eliminate paper checks.

What this means for you

  • Already enrolled with Zelis payments on ZAPP Edge (formerly ACH+)? Great news—no action is needed. Your current setup remains unchanged.
  • Not yet enrolled? To avoid reverting to paper checks after April 1, 2026, you must enroll in one of the electronic options.

Note: This enhancement does not impact financial configuration of your monthly capitation per member per month payments. No action is required.

Your electronic claims payment platform

  • Zelis payments – a powerful platform offering:
    • Streamlined experience: Access payments and data from over 550+ payers using one secure login, all in one convenient platform.
    • Automated posting: 835s sent directly to your practice management system or clearinghouse, eliminating downloads and delays.
    • Real-time insights: Customized reports and payment data from every payer in the Zelis network, all in one place.
  • Health Net ePayment Center
    • A no-cost solution for basic Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) access to remittance data and payment history.

Available claims payment methods

  • Health Net ePayment Center: No-cost EFT and ERA service for basic electronic claims payment needs.
  • ZAPP Edge (formerly ACH+): Advanced electronic payment experience with consolidated claims payments, 835s and support for 550+ payers—all in one place. 
  • Virtual credit card (VCC): Secure, one-time-use cards for flexible claim payment processing, with full access to the Zelis Payment Portal.
  • Paper checks: Issued only if no electronic option is selected.

How to enroll or update your claims payment method

Act today to avoid paper checks

You will receive additional communications from Zelis about EFT enrollment. We strongly encourage you to enroll now to avoid delays and enjoy faster, more secure payments.

Further details, including access to frequently asked questions, will be provided when available.

Need help?

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Clinician Alert: Measles Confirmed in Clackamas County Resident

Measles was confirmed in an unvaccinated Clackamas County resident on January 15, 2026. Oregon Health Authority (OHA) and Clackamas County health officials have not yet determined whether the person has traveled outside of Oregon, or if the case is linked to other known cases.

For more information about testing, infection control, and resources, please view:

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Effective April 1, 2026: New Trillium Medicaid Prior Authorization Requirements

As part of our ongoing work to improve the prior authorization (PA) process for both providers and members, Trillium Community Health Plan wants to share some important updates to our PA requirements. Our goal is to reduce administrative burden, simplify submission and approval processes, and facilitate timely access to appropriate, high-quality care.

Code change details can be found in this notice (PDF). These changes may include:

  • Removing PA requirements based on criticality of review and clinical need.
  • Creating a more uniform set of prior authorization requirements across our markets and lines of businesses, including adding and changing some PA requirements, to simplify processes, reduce confusion for providers, and support future efforts to expand real-time responses to requests.

If you have questions about specific prior authorization codes or how these changes affect your practice, please reach out to your local Provider Engagement representative.

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Clinical Documentation Improvement (CDI) Webinar Series

Trillium, Health Net, and Wellcare providers are invited to join our CDI Webinar Series designed to enhance your understanding of:

  • Risk Adjustment methodologies
  • Accurate and compliant documentation practices
  • Coding strategies aligned with regulatory standards

Who should attend?
Providers, non-physician practitioners, coders, billers, and administrative staff involved in clinical documentation and coding.

All live webinars have CEUs available for AAPC/AHIMA credentials.

To review the schedule and register, view the Clinical Documentation Improvement Webinar Series January-November 2026 document (PDF).

Note: Advance registration is required. If you have questions or need assistance with registration, email us at: CDIWebinars@centene.com

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Trillium Provider Orientation Sessions

Please join our Provider Engagement team for a hosted virtual orientation session for all new contracted providers and currently contracted providers who would like updates for 2026.

All sessions will contain the same content and will cover the following topics important to providers, including:

  • Trillium website – tips and tour of resources  
  • Introduction to provider portals      
  • Credentialing     
  • Claims submission     
  • Prior authorization check tool   
  • Interpreter services     
  • Family planning and women’s healthcare services   
  • Population Health case management services      
  • Behavioral Health services    
  • Free clinical trainings      
  • Access and availability provider appointment standards     
  • How to connect with your dedicated Provider Engagement Account Manager 

Note: If you need accommodations or would like to schedule an individual session for your team/provider group, please contact ORProviderExperience@TrilliumCHP.com.

We look forward to connecting with you!

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