September 25, 2025 / by Health Plan / Alerts
Date: September 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers, Specialists, Behavioral Health Providers, and Ancillary Providers Type: Informational Subject: California Health Coalition Event Business: Medi-Cal Managed Care California Department Public Health (CDPH) State Public Health Officer Dr. Erica Pan, in collaboration with the [...]
Read more
Health Plan of San Joaquin provider Alerts
California Health Coalition Event
September 25, 2025 / by Health Plan / Alerts
Date: September 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers, Specialists, Behavioral Health Providers, and Ancillary Providers Type: Informational Subject: California Health Coalition Event Business: Medi-Cal Managed Care California Department Public Health (CDPH) State Public Health Officer Dr. Erica Pan, in collaboration with the [...]Read more
Do not submit a Provider Dispute for Remittance Advices with Blank or Missing Claim Line Information
September 24, 2025 / by Health Plan / Alerts
Date: September 24, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers, Facilities, Hospitals, Clinics Type: Process Update Subject: Do not submit a Provider Dispute for Remittance Advices with Blank or Missing Claim Line Information Business: Medi-Cal Managed Care We are aware of a system issue related to [...]Read more
Breast Cancer Screening (BCS-E) & Cervical Cancer Screening (CCSE)
September 24, 2025 / by Health Plan / Alerts
Date: September 24, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan CONTRACTED PCPs & OBGYN Type: Informational/Educational Subject: Breast Cancer Screening (BCS-E) & Cervical Cancer Screening (CCSE) Business: Medi-Cal Managed Care Healthcare Effectiveness Data Information Set (HEDIS) Update Measurement Year 2025 Cancer Screening for Women Measures Update-BCS-E-Breast Cancer [...]Read more
Free Zoom Training: Perinatal Substance Use Disorder 101 Presented by Postpartum Support International
September 24, 2025 / by Health Plan / Alerts
Date: September 23, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Primary Care Providers and BH Providers Type: Informational/Educational Subject: Free Zoom Training: Perinatal Substance Use Disorder 101 Presented by Postpartum Support International Business: Medi-Cal Managed Care The Policy Center, Postpartum Support International and Colorado Department of [...]Read more
Free Zoom Webinar – Addiction 101: Understanding Lived Experience and the Science to Prevent Overdose Sponsored by California Overdose Prevention Network (COPN)
September 22, 2025 / by Health Plan / Alerts
Date: September 22, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers and BH Providers Type: Informational/Educational Subject: Free Zoom Webinar - Addiction 101: Understanding Lived Experience and the Science to Prevent Overdose Sponsored by California Overdose Prevention Network (COPN) Business: Medi-Cal Managed Care The California [...]Read more
2025 Provider Appointment Availability Survey (PAAS)
September 19, 2025 / by Health Plan / Alerts
Date: September 19, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers, Specialists, Behavioral Health Type: Regulatory Subject: 2025 Provider Appointment Availability Survey (PAAS) Business: Medi-Cal Managed Care The Provider Appointment Availability Survey (PAAS) has begun. Health Plan is required by the Department of Health Care [...]Read more
Changes to Prior Authorization Search Tool in Provider Portal
September 11, 2025 / by Health Plan / Alerts
Date: September 11, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers, Facilities and Hospitals Type: Informational Subject: Changes to Prior Authorization Search Tool in Provider Portal Business: Medi-Cal Managed Care Health Plan’s current claims processing system upgrade to QNXT 2.0 scheduled for September 12, 2025, includes an [...]Read more
REMINDER IMPORTANT! PLEASE READ: Claims Processing System Upgrade – QNXT 2.0 Go-Live Moved to 9/12/2025
September 10, 2025 / by Health Plan / Alerts
Date: September 10, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers, Facilities and Hospitals Type: Informational Subject: REMINDER IMPORTANT! PLEASE READ: Claims Processing System Upgrade – QNXT 2.0 Go-Live Moved to 9/12/2025 Business: Medi-Cal Managed Care Health Plan recently announced that our current claims processing system will [...]Read more
Peer-to-Peer Update
September 5, 2025 / by Health Plan / Alerts
Date: September 3, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Providers and facilities Type: Procedural Update Subject: Peer-to-Peer Update Business: Medi-Cal Managed Care A treating provider can request a peer-to-peer discussion with Health Plan’s medical director within 5 business days of receiving notification of a denied [...]Read more
DHCS Release of Request for Applications for Behavioral Health Continuum Infrastructure Program – Round 2: Unmet Needs
September 5, 2025 / by Health Plan / Alerts
Date: September 3, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Informational Subject: DHCS Release of Request for Applications for Behavioral Health Continuum Infrastructure Program - Round 2: Unmet Needs Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) has released the Bond Behavioral [...]Read more