REMINDER- Authorization Required on Claims

July 6, 2022 / by Health Plan / Alerts

Date: July 5, 2022 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Subject: REMINDER- Authorization Required on Claims Business: Medi-Cal Managed Care An internal claims audit revealed that the prior authorization number (entered on a CMS 1500 claim form) and the treatment authorization number (entered on a UB04 claim form) [...]

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Proposition 56 Value-Based Payment Programing Has Ended

July 6, 2022 / by Health Plan / Alerts

Date: July 5, 2022 To: HPSJ Primary Care Providers (PCP) and Contracted Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Proposition 56 Value-Based Payment Programing Has Ended Business: Medi-Cal Managed Care The Value-Based Payment (VBP) Program has ended effective June 30, 2022. The VBP Program was directed to Managed Care Plans (MCPs) to make [...]

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Revised DHCS Facility Site Review and Medical Record Review Tools and Standards

July 1, 2022 / by Health Plan / Alerts

Date: July 1, 2022 To: Health Plan of San Joaquin (HPSJ) PCP’s and FQHCs From: HPSJ Quality Management Department Type: Informational/Regulatory Subject: Revised DHCS Facility Site Review and Medical Record Review Tools and Standards Business: Medi-Cal Managed Care Beginning July 1, 2022, the Department of Health Care Services (DHCS) will be implementing the use of [...]

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2022 Mandatory Annual Trainings Final Reminder

July 1, 2022 / by Health Plan / Alerts

Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers & Facilities From: Health Plan of San Joaquin Subject: 2022 Mandatory Annual Trainings Final Reminder Business: Medi-Cal ACTION REQUIRED Please complete ALL THREE trainings by June 30, 2022 Annual training is mandated by California’s Department of Health Care Services (DHCS) and the [...]

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Medical Benefit Updates

June 30, 2022 / by Health Plan / Alerts

Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective September 5, 2022, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit: Code J2357 - INJECTION, OMALIZUMAB [...]

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Reminder: Phase 2: ECM and Community Supports – San Joaquin and Stanislaus Counties

June 30, 2022 / by Health Plan / Alerts

Date: June 30, 2022 To: HPSJ Primary Care Providers, Specialists, Hospitals and Facilities From: Health Plan of San Joaquin Subject: Reminder: Phase 2: ECM and Community Supports – San Joaquin and Stanislaus Counties Business: Medi-Cal Enhanced Care Management and Community Supports Starting in January of 2022, new benefits and services called Enhanced Care Management (ECM) [...]

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2022 Mandatory Annual Training – Reminder Table

June 29, 2022 / by Health Plan / Alerts

Date: June 17, 2022 To: Health Plan of San Joaquin Practitioners, Contracted Providers, Facilities, and Behavioral Health Providers From: Health Plan of San Joaquin Subject: 2022 Mandatory Annual Training – Reminder Table Business: Medi-Cal   Type of Training Requirement Due Date Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a federal law that required […]

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