Update – Grievance Process

Date: June 4, 2021 To: Health Plan of San Joaquin Contracted Practitioners, Providers & Facilities From: Health Plan of San Joaquin Subject: Update – Grievance Process Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) require Health Plan of San Joaquin (HPSJ) to monitor and [...]

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TOP TOPICS Monthly Spotlights Just for HPSJ Providers, June 2021

Early CalFires Season – Helping Providers & Members Prepare CDC has tools to help serve our members at www.hpsj.com/providers/. For members, HPSJ offers detailed support at www.hpsj.com/stay-safe-during-fire-season/. When it comes to dangerous fire season air quality, HPSJ asks members to KNOW YOUR COLORS. The EPA’s AirNow site has information on how to stay safe, at [...]

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HEDIS season 2021 Audit Completed

Date: May 25, 2021 To: Health Plan of San Joaquin (HPSJ) CONTRACTED PROVIDERS From: Health Plan of San Joaquin Subject: HEDIS season 2021 Audit Completed Business: Medi-Cal The HEDIS team in the Quality Department of Health Plan of San Joaquin (HPSJ) would like to thank you for your efforts and delivery of medical records during [...]

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KNOW YOUR COLORS – Protect Your Health from California Fires Season Deadly Smoke

California Fire season has started early this year. Health Plan of San Joaquin (HPSJ) has facts to help you prep, with guidance at https://www.hpsj.com/stay-safe-during-fire-season/. Air quality from the fires finds all Californians beyond the fire warning zone. To protect loved ones KNOW YOUR COLORS when it comes to air quality for this year’s fire season. [...]

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UPDATE Value Based Payment (VBP) Program

Date: May 18, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: ~UPDATE~ Value Based Payment (VBP) Program Business: Medi-Cal Managed Care The following is an update for the Value Based Payment (VBP) Program operations. HPSJ is in the process of implementing a technical update to our [...]

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Claims Look-Up Tool – For Non-Contracted Providers

Date: May 18, 2021 To: Health Plan of San Joaquin (HPSJ) Contracted and Non-Contracted Providers From: Health Plan of San Joaquin Subject: Claims Look-Up Tool – For Non-Contracted Providers Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) has a helpful tool, outside of the provider portal, for contracted and non-contracted providers to track [...]

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Formulary Update – Effective 07/19/2021

Date: May 13, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update - Effective 07/19/2021 Business: Medi-Cal Effective 07/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Teprotumumab (Tepezza) 500mg vial: Reserved for [...]

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UPDATE– DHCS Guidance – COVID-19 Vaccines & Vaccination Administration

Date: May 5, 2021 To: Health Plan of San Joaquin (HPSJ) Providers and Pharmacists From: Health Plan of San Joaquin Subject: UPDATE– DHCS Guidance – COVID-19 Vaccines & Vaccination Administration Business: Medi-Cal Managed Care The California Department of Health Care Services (DHCS) has now issued updated guidance for all Medi-Cal managed care health care plans [...]

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