Flu Season is Coming – It’s best to get your flu shot early

At last! We are getting a break from all of that summer heat. That can mean only one thing: It’s almost flu season. “Flu can be harmful for kids and households. According to the federal Centers for Disease Prevention and Control (CDC), between 6,000 and 26,000 children younger than 5 are sent to the hospital [...]

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**Reminder** Provider Dispute Resolution (PDR) Submission

Date: September 4, 2019 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: **Reminder** Provider Dispute Resolution (PDR) Submission Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) would like to remind providers and facilities of proper protocol for submitting Provider Dispute Resolutions (PDRs). Contracted Providers must […]

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Health Plan of San Joaquin (HPSJ) is spreading the word – September is cholesterol teaching month

(French Camp, CA) – Health Plan of San Joaquin (HPSJ) is letting members and everyone throughout their San Joaquin and Stanislaus county service area know that September is national Cholesterol Teaching Month. The questions driving this nationwide campaign: Do you know what you should about cholesterol—how to keep it at a healthy level to help […]

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Clinical Review Update: Morphine Equivalent Daily Dose

Learning Objectives: Describe morphine equivalent daily dose (MEDD) and how it is being used to indicate potential dose-related risk for prescription opioid overdose. Summarize best practices for prescribing opioids. Identify resources available that promote responsible opioid prescribing, including online and mobile applications for calculation of morphine milligram equivalency. Describe recent legislation in California related to […]

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August 2019 – Claims corner newsletter

GO447—New HEDIS Tip Sheet (Provider Alert 7.11.2019) The annual HEDIS Provider Tip Sheet is a tool used to inform providers of the value set codes published at the national level by the measure steward (the National Committee for Quality Assurance). The most recent version of the Provider Tip Sheet is posted on DRE. In the […]

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Test your cholesterol smarts

Across the country, September is Cholesterol Teaching Month. Do you know what you should about cholesterol—how to keep it at a healthy level to help stop heart disease? “These FIVE MUST-KNOW facts about cholesterol can help you get started,” says HPSJ Health Education Specialist Jessica Nila. 1. Your body needs cholesterol. This waxy substance is […]

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HEDIS Training Breakfast & Learn

Date: August 5, 2019 To: Health Plan of San Joaquin (HPSJ) Network: PCP, OB/GYN, Behavioral Health From: HPSJ Provider Services Department Subject: HEDIS Training BREAKFAST & LEARN – Practical Tips for Your Success This Year Our HPSJ providers are essential partners in delivering care to our members. Because of your valued contributions, we are glad […]

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DHCS Encounter Requirement – NDC Required

Date: August 5, 2019 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: DHCS Encounter Requirement – NDC Required    Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) was recently informed the California Department of Health Care Services (DHCS) is requiring the National Drug Code (NDC) […]

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NEW from Health Plan of San Joaquin (HPSJ) – Handy, One-Page Vaccination Chart for Children Well-Child Check-Up & Shots: Children from birth to 17 years old

(French Camp, CA) – Health Plan of San Joaquin (HPSJ) has a new one-page way to guide parents in keeping up with their child’s Well-Child check-ups, vaccinations, when to screen for hearing and vision, blood screening, and when to ask about flu shots. The chart, in English and Spanish, is based on recommendations from the […]

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Health Plan of San Joaquin (HPSJ) Announces Compliance & Privacy Officer for Not-For-Profit Public Health Plan

(French Camp, CA) – Health Plan of San Joaquin (HPSJ) has announced that Sunny T. Cooper, MHS, CHIE, has joined HPSJ as Compliance and Privacy Officer. Cooper, who comes to HPSJ with extensive senior executive experience in Medicaid (known as Medi-Cal in California), as well as Medicare and commercial health insurance, is a widely respected […]

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