Health Plan of San Joaquin provider Alerts

Skilled Nursing Facilities – Long Term Care (LTC) Training

Date: December 5, 2022 To: HPSJ Contracted and Non-Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Type: Regulatory/Informational Subject: Skilled Nursing Facilities - Long Term Care (LTC) Training Business: Medi-Cal Managed Care Please join us on December 15, 2022, from 12:30 p.m.-1:30 p.m., for a Virtual Provider Look and Learn Session on [...]

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Immunizations for Adolescents (IMA) Reminder

Date: December 2, 2022 To: HPSJ Contracted Primary Care Providers and Pediatrics From: Health Plan of San Joaquin (HPSJ) Type: Informational/Reminder Subject: Provider Alert Website Correction regarding - Immunizations for Adolescent (IMA) Reminder Business: Medi-Cal Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2022 The following is a reminder regarding the Immunizations for Adolescents (IMA) [...]

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Hedis Preseason Reminder for Measurement Year 2022

Date: December 1, 2022 To: HPSJ Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Type: Informational/Educational Subject: HEDIS Preseason Reminder for Measurement Year 2022 Business: Medi-Cal Managed Care REMINDER Healthcare Effectiveness Data and Information Set (HEDIS) Medical Record Review (MRR) season is coming. Medical Record Collection for HEDIS Hybrid measures begins February [...]

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Medi-Cal Pharmacy (Rx) Update – Rejection Code 816

Date: December 1, 2022 To: Health Plan of San Joaquin (HPSJ) Practitioners and Facilities From: Health Plan of San Joaquin (HPSJ) Type: Informational/Educational Subject: Medi-Cal Pharmacy (Rx) Update – REJECTION CODE 816 Business: Medi-Cal Outpatient pharmacy benefits were transitioned to Medi-Cal Rx on 1-1-2022. Due to the benefit transitioning, some medications are paid for by [...]

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Provider Manual Update 45 Day Notice

Date: November 23, 2022 To: HPSJ Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Provider Manual Update 45 Day Notice Business: Medi-Cal Managed Care The following information serves as an official 45-business day notice regarding updates to the Provider Manual. Health Plan of San Joaquin (HPSJ) has updated the Provider Manual [...]

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2023 Enhanced Care Management & Community Supports

Date: November 21, 2022 To: HPSJ Primary Care Providers, Specialists, Hospitals and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: 2023 Enhanced Care Management & Community Supports Business: Medi-Cal Managed Care Enhanced Care Management (ECM) and Community Supports (CS) are available for Medi-Cal members in San Joaquin County and Stanislaus County. Starting in 2023, [...]

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Fluoride Varnish and Supplementation Updates and Reminder

Date: November 18, 2022 To: HPSJ Primary Care Providers and Specialists From: Health Plan of San Joaquin (HPSJ) Subject: Fluoride Varnish and Supplementation Updates and Reminder Business: Medi-Cal Health Plan of San Joaquin (HPSJ) would like to remind our providers that fluoride varnish can be applied at any well visit for children between 6 months [...]

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Reminder – Provider Overpayments

Date: November 18, 2022 To: HPSJ Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Reminder - Provider Overpayments Business: Medi-Cal Managed Care In accordance with the California Department of Health Care Services (DHCS) All Plan Letters (APLs), 17-003 Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to [...]

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Provider Preventable Conditions (PPC)

Date: November 8, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Provider Preventable Conditions (PPC) Business: Medi-Cal Managed Care Provider Preventable Conditions (PPC) Reminder Under Section 2702 of the Patient Protection and Affordable Care Act (Pub. L. 111-148) and federal regulations at 42 CFR 447.26, Medi-Cal providers must [...]

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Contraceptive Care (CCP) – Postpartum Women ages 21 to 44 Reminder

Date: November 7, 2022 To: HPSJ Contracted Primary Care Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Contraceptive Care (CCP) - Postpartum Women ages 21 to 44 Reminder Business: Medi-Cal Managed Care Accountability Sets (MCAS) Measure The following is reminder regarding Contraceptive Care (CCP) - Postpartum Women ages 21-44. Description: Women ages [...]

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