April 9, 2025 / by Health Plan / Alerts
Date: April 09, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan PCP's, FQHC's, RHC's, Behavioral Health, SCP's Type: Informational Subject: Reminder: Submit Outstanding Claims and Encounters Business: Medi-Cal Managed Care Health Plan would like to remind that timely submission of claims and encounters increases the likelihood of timely [...]
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Health Plan of San Joaquin provider Alerts
2025 Income Eligibility Guidelines for the Every Woman Counts (EWC) Program
April 18, 2025 / by Health Plan / Alerts
Date: April 16, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers, Practitioners, and Facilities Type: Informational Subject: 2025 Income Eligibility Guidelines for the Every Woman Counts (EWC) Program Business: Medi-Cal Managed Care The Health and Human Services (HHS) Federal Poverty Guidelines (FPG) are used to determine the financial eligibility [...]Read more
Medi-Cal Pharmacy (Rx) Update – Completion of Pediatric Integration
April 18, 2025 / by Health Plan / Alerts
Date: April 16, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational Subject: Medi-Cal Pharmacy (Rx) Update – Completion of Pediatric Integration Business: Medi-Cal Managed Care EFFECTIVE APRIL 25, 2025, Medi-Cal Rx will complete the implementation of claim edits and prior authorization (PA) [...]Read more
Claims Editing System (CES)- Quarterly Update – April 2025
April 9, 2025 / by Health Plan / Alerts
Date: April 09, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers, Practitioners, Hospitals and Facilities Type: Informational Subject: Claims Editing System (CES) - Quarterly Update - April 2025 Business: Medi-Cal Managed Care Effective April 11, 2025, Health Plan will implement a quarterly update to the Claims Editing [...]Read more
Reminder: DHCS Encounter Requirement – Discharge Hour
April 9, 2025 / by Health Plan / Alerts
Date: April 09, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers and Facilities Type: Informational Subject: Reminder: DHCS Encounter Requirement – Discharge Hour Business: Medi-Cal Managed Care As part of Health Plan’s ongoing efforts to ensure accurate and compliant claims processing, we would like to remind providers [...]Read more
Reminder: Submit Outstanding Claims and Encounters
April 9, 2025 / by Health Plan / Alerts
Date: April 09, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan PCP's, FQHC's, RHC's, Behavioral Health, SCP's Type: Informational Subject: Reminder: Submit Outstanding Claims and Encounters Business: Medi-Cal Managed Care Health Plan would like to remind that timely submission of claims and encounters increases the likelihood of timely [...]Read more
Department of Health Care Services (DHCS), All Plan Letter (APL) 23-029- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities
April 9, 2025 / by Health Plan / Alerts
Date: April 09, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers and Practitioners Type: Regulatory Subject: Department of Health Care Services (DHCS), All Plan Letter (APL) 23-029- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities Business: Medi-Cal Managed Care The Department of Health [...]Read more
Medical Benefit Update – Effective June 9, 2025
April 1, 2025 / by Health Plan / Alerts
Date: April 01, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Pharmacy and Therapeutics Committee To: Health Plan Providers and Physicians Type: Formulary Subject: Medical Benefit Update – Effective June 9, 2025 Business: Medi-Cal Managed Care Effective June 9, 2025, the Pharmacy and Therapeutics Committee has approved the following changes to [...]Read more
3rd Annual Black Maternal Health Symposium- San Joaquin County
April 1, 2025 / by Health Plan / Alerts
Date: April 01, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers and OBGYNs Type: Informational/Educational Subject: Save the Date: Events in Partnership with Valley Children’s Healthcare – April 2025 Business: Medi-Cal Managed Care Health Plan is proud to partner with local Community Based Organizations (CBO)’s [...]Read more
Save the Date: Events in Partnership with Valley Children’s Healthcare – April 2025
April 1, 2025 / by Health Plan / Alerts
Date: April 01, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers Type: Event Subject: Save the Date: Events in Partnership with Valley Children’s Healthcare – April 2025 Business: Medi-Cal Managed Care Health Plan is pleased to announce two free in-person events, in partnership with Valley [...]Read more
Medi-Cal In-Person Training Event – April 2025
March 28, 2025 / by Health Plan / Alerts
Date: March 26, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Event Subject: Medi-Cal In-Person Training Event – April 2025 Business: Medi-Cal Managed Care Medi-Cal’s Outreach and Education team, and the Department of Health Care Services (DHCS) are pleased to announce an in-person training [...]Read more