Claims Editing System (CES)- Quarterly Update
| Date: | September 20, 2024 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) |
| To: | Health Plan Providers and Practitioners |
| Type: | Regulatory |
| Subject: | Claims Editing System (CES)- Quarterly Update |
| Business: | Medi-Cal Managed Care |
We recently notified you that Health Plan implemented a Claims Editing System (CES) on April 1, 2024. As the system has now been operational for a few months, effective September 20, 2024, we will implement a quarterly update to the CES to align with the latest Medi-Cal updates. This change will ensure our adjudication system is aligned with Medi-Cal Regulations to include but not limited to, frequency, edits, and limits.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website WWW.HPSJ-MVHP.ORG
