April 12, 2024 / by HPSJ / Alerts
Date: April 10, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Physicians, Providers, and Facilities Type: Formulary Subject: Medical Benefit Update Business: Medi-Cal Managed Care Effective June 13, 2024, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code 91304 - SARSCOV2 [...]
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Health Plan of San Joaquin provider Alerts
Reminder: Mandatory Annual Trainings – Complete by 06/30/2024
April 24, 2024 / by Araceli Gallo / Alerts
Date: April 24, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Providers and Practitioners Type: Regulatory Subject: Reminder: Mandatory Annual Trainings - Complete by 06/30/2024 Business: Medi-Cal Managed Care ACTION REQUIRED This is a reminder that the due date is approaching for Health Plan’s mandatory trainings for [...]Read more
Implementation of Transitional Care Services (TCS) Phone Line
April 18, 2024 / by Cris Bauer / Alerts
Date: April 17, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Practitioners and Facilities Type: Informational Subject: Implementation of Transitional Care Services (TCS) Phone Line Business: Medi-Cal Managed Care Health Plan would like to inform providers that our Transitional Care Services (TCS) phone line is now available [...]Read more
The Department of Healthcare Services Skilled Nursing Facilities Workforce and Quality Improvement Program
April 18, 2024 / by Cris Bauer / Alerts
Date: April 17, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Skilled Nursing Facilities Type: Regulatory Subject: The Department of Healthcare Services Skilled Nursing Facilities Workforce and Quality Improvement Program Business: Medi-Cal Managed Care The Department of Healthcare Services (DHCS) Skilled Nursing Facilities (SNF) Workforce and Quality [...]Read more
Annual Timely Access Report – Measurement Year 2022
April 17, 2024 / by Araceli Gallo / Alerts
Date: April 17, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: Annual Timely Access Report – Measurement Year 2022 Business: Medi-Cal Managed Care The Department of Managed Health Care (DMHC) published the Annual Timely Access Report results for Measurement Year (MY) 2022. The report summarizes provider appointment availability [...]Read more
Medical Benefit Update
April 12, 2024 / by HPSJ / Alerts
Date: April 10, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Physicians, Providers, and Facilities Type: Formulary Subject: Medical Benefit Update Business: Medi-Cal Managed Care Effective June 13, 2024, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code 91304 - SARSCOV2 [...]Read more
Post Stabilization Information for Hospitals
April 11, 2024 / by HPSJ / Alerts
Date: April 10, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers, Facilities, and Hospitals Type: Regulatory Subject: Post Stabilization Information for Hospitals Business: Medi-Cal Managed Care California Health and Safety Code1262.8, includes various provisions regarding emergency and post-stabilization care. Post-stabilization care is defined as medically necessary [...]Read more
Incorrect Check Payments Issued
April 9, 2024 / by HPSJ / Alerts
Date: April 09, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: Incorrect Check Payments Issued Business: Medi-Cal Managed Care This alert is to notify you that fee-for-service (FFS) payment checks dated 4/2/2024 were mailed and subsequently canceled after it was identified that payments [...]Read more
Health Alert- Measles
March 27, 2024 / by HPSJ / Alerts
Date: March 27, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers, Hospitals, and Facilities Type: Regulatory Subject: Health Alert- Measles Business: Medi-Cal Managed Care The Health Plan was recently informed of a confirmed case of Measles in Stanislaus County. Please review the attached health alert which [...]Read more
Specialist Referral Form No Longer Required
March 27, 2024 / by HPSJ / Alerts
Date: March 27, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Facilities Type: Informational/Educational Subject: Specialist Referral Form No Longer Required Business: Medi-Cal Managed Care The Specialist Referral Form is no longer required by Health Plan. Effective immediately, the form has been removed from hpsj.com. [...]Read more
IMPORTANT: Change Healthcare Payments Notification – Update 2
March 22, 2024 / by HPSJ / Alerts, provider page alerts
Date: March 21, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: IMPORTANT: Change Healthcare Payments Notification – Update 2 Business: Medi-Cal Managed Care The remittance advice (RA)/explanation of payment (EOP) details is now available starting today. All providers will now have the ability [...]Read more