Health Plan of San Joaquin provider Alerts

Formulary Update – Effective November 30th, 2021

Date: September 22 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 November 30th, 2021 Business: Medi-Cal Managed Care Effective 11/30/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Eluxadoline (Viberzi) 75 [...]

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Reminder: Immunization follow up should be conducted by age 2

Date: September 22, 2021 To: Health Plan of San Joaquin (HPSJ) Contracted PCPs, Clinics, Pediatrics Offices From: Health Plan of San Joaquin Subject: Child Immunization Status UPDATE – Reminder: Immunization follow up should be conducted by age 2 Business: Medi-Cal Managed Care SUMMARY FOR MEASURE YEAR (MY) 2021 Childhood Immunization Status: Combination 10 Providers, please [...]

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Pain management network updates

In recent months, there have been several changes to Health Plan of San Joaquin’s (HPSJ) contracted Pain Management network. Please see the list of providers below that are accepting new patients currently. For a full list of all contracted pain management providers, visit the Doctors Referral Express (DRE) Provider Portal; located at https://www.hpsj.com/find-a-doctor/ or please […]

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HPSJ Members – myRewards Postcard Reminders

Date: September 8, 2021 To: Health Plan of San Joaquin (HPSJ) CONTRACTED Providers From: Health Plan of San Joaquin Subject: HPSJ Members – myRewards Postcard Reminders Business: Medi-Cal Managed Care HPSJ myRewards Program Incentives for Members – Closing Gaps in Care, Improving HEDIS rates Since August, Health Plan of San Joaquin patients began receiving myRewards [...]

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REMINDER: MANDATORY– Cultural Competency Training2021

Date: September 7, 2021 To: Health Plan of San Joaquin (HPSJ) Providers From: Health Plan of San Joaquin Subject: REMINDER: MANDATORY– Cultural Competency Training 2021 Business: Medi-Cal Annual Training Requirement ACTION REQUIRED Annual training is mandated by California’s Department of Health Care Services (DHCS) and the federal Centers for Medicare and Medicaid Services (CMS) to [...]

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REMINDER: MANDATORY Fraud, Waste and Abuse (FWA) Training 2021

Date: September 7, 2021 To: Health Plan of San Joaquin (HPSJ) Providers From: Health Plan of San Joaquin Subject: REMINDER: MANDATORY Fraud, Waste and Abuse (FWA) Training 2021 Business: Medi-Cal Annual Training Requirement ACTION REQUIRED Annual Fraud, Waste and Abuse (FWA) training for ALL PROVIDERS Each year, all providers are required to complete FWA training [...]

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UPDATE: Monthly Capitation (CAP) Payments

Date: September 1, 2021 To: Health Plan of San Joaquin (HPSJ) All Contracted From: Health Plan of San Joaquin Subject: UPDATE: Monthly Capitation (CAP) Payments Business: Medi-Cal Managed Care Due to the Labor Day holiday, there may be a delay in the normal delivery schedule for your monthly CAP payment. We want you to be [...]

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California Electronic Visit Verification Provider Survey

Date: August 24, 2021 To: Network Providers Personal Care Services (PCS) and/or Home Health Care Services (HHCS) From: Health Plan of San Joaquin (HPSJ) Subject: California Electronic Visit Verification Provider Survey Business: Medi-Ca YOUR FEEDBACK IS IMPORTANT Dear Provider Agency, Please complete the Electronic Visit Verification (EVV) provider survey by September 1, 2021 https://www.surveymonkey.com/r/S328MLX We [...]

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MANDATORY – Fraud, Waste and Abuse (FWA) Training 2021

Date: August 20, 2021 To: Health Plan of San Joaquin (HPSJ) Providers From: Health Plan of San Joaquin Subject: MANDATORY – Fraud, Waste and Abuse (FWA) Training 2021 Business: Medi-Cal ACTION REQUIRED Annual Fraud, Waste and Abuse (FWA) training for ALL PROVIDERS Each year, all providers are required to complete FWA training and then attest [...]

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Mandatory Training 2021 – Cultural Competency and Sensitivity

Date: August 20, 2021 To: Health Plan of San Joaquin Contracted Provider Network and Delegated Entities From: Health Plan of San Joaquin Subject: Mandatory Training 2021 – Cultural Competency and Sensitivity Business: Medi-Cal Managed Care ACTION REQUIRED Annual training is mandated by California’s Department of Health Care Services (DHCS) and the federal Centers for Medicare [...]

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