May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Long-Term-Care Facilities From: HPSJ Type: Regulatory/Informational Subject: Supplemental Payment Business: Medi-Cal Managed Care For 2023, Health Plan of San Joaquin (HPSJ) will continue paying a supplemental payment for the first 45 days of admission. Starting July 5, 2023, to receive this supplemental payment, facilities [...]
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Health Plan of San Joaquin provider Alerts
Dual Members: Overpayments
May 30, 2023 / by HPSJ / Alerts
Date: May 30, 2023 To: Health Plan of San Joaquin (HPSJ) Long Term Care Providers From: HPSJ Type: Announcement Subject: Dual Members: Overpayments Business: Medi-Cal Managed Care Medicare/Medi-Cal (Dual) HPSJ Members & Long-Term Care Claims for Medicare/Medi-Cal recipients must first be billed to the appropriate Medicare carrier or intermediary for processing of Medicare benefits. Medi-Cal [...]Read more
Long Term Care – Share of Cost (SOC) Value Codes
May 22, 2023 / by HPSJ / Alerts
Date: May 22, 2023 To: Health Plan of San Joaquin (HPSJ) Providers and Facilities From: HPSJ Type: Regulatory/Informational Subject: Long Term Care – Share of Cost (SOC) Value Codes Business: Medi-Cal Managed Care In accordance with guidelines from the Department of Health Care Services (DHCS), providers may collect Share of Cost (SOC) payments from a [...]Read more
Vendor Update
May 22, 2023 / by HPSJ / Alerts
Date: May 22, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners From: HPSJ Type: Informational Subject: Vendor Update Business: Medi-Cal Managed Care Effective May 1, 2023, HPSJ is no longer offering Diabetes Prevention Program through Melon Health. We apologize to our members who may be impacted by this change. HPSJ is working to find [...]Read more
Supplemental Payment
May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Long-Term-Care Facilities From: HPSJ Type: Regulatory/Informational Subject: Supplemental Payment Business: Medi-Cal Managed Care For 2023, Health Plan of San Joaquin (HPSJ) will continue paying a supplemental payment for the first 45 days of admission. Starting July 5, 2023, to receive this supplemental payment, facilities [...]Read more
Skilled Nursing Facility/Long Term Care Payment Issue
May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Skilled Nursing Facility/Long Term Care From: HPSJ Type: Regulatory/Informational Subject: Skilled Nursing Facility/Long Term Care Payment Issue Business: Medi-Cal Managed Care We regret to inform you that due to a technical issue that occurred on March 31, 2023, some long-term care claims may [...]Read more
UPDATE- Monthly Capitation (CAP) Payment Scheduled for May 2023
May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP) From: HPSJ Type: Informational/Educational Subject: UPDATE- Monthly Capitation (CAP) Payment Scheduled for May 2023 Business: Medi-Cal Managed Care This notice is to inform you that your May 2023 capitation payment will be delayed. We want you to be aware of [...]Read more
Skilled Nursing Facilities (SNF) – Preadmission Screening and Resident Review (PASRR) Responsibility Change
April 26, 2023 / by HPSJ / Alerts
Date: April 26, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Hospitals and Skilled Nursing Facilities From: HPSJ Type: Informational/Educational Subject: Skilled Nursing Facilities (SNF) - Preadmission Screening and Resident Review (PASRR) Responsibility Change Business: Medi-Cal Managed Care This Provider Alert serves as a reminder that the Preadmission Screening (PAS) is a federal [...]Read more
Medi-Cal Pharmacy (Rx) Update – Reinstatement of Prior Authorizations for Phase III and IV
April 26, 2023 / by HPSJ / Alerts
Date: April 26, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners and Facilities From: HPSJ Type: Informational/Educational Subject: Medi-Cal Pharmacy (Rx) Update – Reinstatement of Prior Authorizations for Phase III and IV Business: Medi-Cal Managed Care Outpatient pharmacy benefits were transitioned to Medi-Cal Rx on 1-1-2022. Due to the benefit transitioning, some medications are [...]Read more
Medi-Cal Enrollment Procedure and Exemptions for Remote Mental Health Services
April 26, 2023 / by HPSJ / Alerts
Date: April 26, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners, Facilities, Behavioral Health Care Providers From: HPSJ Type: Informational/Educational Subject: Medi-Cal Enrollment Procedure and Exemptions for Remote Mental Health Services Business: Medi-Cal Managed Care Effective March 29, 2023, the Department of Health Care Services (DHCS) is establishing Medi-Cal provider enrollment requirements and procedures [...]Read more
Discontinuation of COVID-19 Emergency Fee-For-Service Medi-Cal Enrollment
April 26, 2023 / by HPSJ / Alerts
Date: April 26, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners and Facilities From: HPSJ Type: Informational/Educational Subject: Discontinuation of COVID-19 Emergency Fee-For-Service Medi-Cal Enrollment Business: Medi-Cal Managed Care Effective March 29, 2023, the Department of Health Care Services (DHCS) is discontinuing the provider enrollment flexibilities authorized by the Section 1135 waiver. Providers temporarily [...]Read more