June 20, 2025 / by Health Plan / Alerts
Date: June 18, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Primary Care Physicians, Obstetricians, Pediatricians, and Federally Qualified Health Centers Type: Informational Subject: MyRewards Member Incentive Update Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ)/Mountain Valley Health Plan (MVHP) is enhancing its member incentive program to [...]
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Health Plan of San Joaquin provider Alerts
Claims Processing System Upgrade – QNXT 2.0 Go-Live 7/25/2025
June 26, 2025 / by Health Plan / Alerts
Date: June 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Facilities and Hospitals Type: Informational Subject: Claims Processing System Upgrade - QNXT 2.0 Go-Live 7/25/2025 Business: Medi-Cal Managed Care Health Plan is proud to announce that our current claims processing system will be upgraded to QNXT 2.0, [...]Read more
Behavioral Health Provider Credentialing
June 26, 2025 / by Health Plan / Alerts
Date: June 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Applied Behavior Analysis (ABA) Providers Type: Procedural Update Subject: Behavioral Health Provider Credentialing Business: Medi-Cal Managed Care As of May 1st, 2025, Health Plan started credentialing Board Certified Behavioral Analyst (BCBA) providers, to be in compliance with [...]Read more
Jiva System Upgrade
June 26, 2025 / by Health Plan / Alerts
Date: June 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers Type: Informational Subject: Jiva System Upgrade Business: Medi-Cal Managed Care Health Plan's medical management system, Jiva, will be temporarily down for an upgrade. The upgrade is planned for this weekend and will support additional functionality. During [...]Read more
2025 Subacute Care Program Updates
June 20, 2025 / by Health Plan / Alerts
Date: June 18, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Skilled Nursing Facilities and Long-Term Care Type: Informational/Educational Subject: 2025 Subacute Care Program Updates Business: Medi-Cal Managed Care The Health Plan would like to share additional guidance related to the Subacute Care Program to support accurate billing [...]Read more
MyRewards Member Incentive Update
June 20, 2025 / by Health Plan / Alerts
Date: June 18, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Primary Care Physicians, Obstetricians, Pediatricians, and Federally Qualified Health Centers Type: Informational Subject: MyRewards Member Incentive Update Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ)/Mountain Valley Health Plan (MVHP) is enhancing its member incentive program to [...]Read more
Adventist Health Termination
June 12, 2025 / by Health Plan / Alerts
Date: June 11, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Facilities and Hospitals Type: Informational Subject: Adventist Health Termination Business: Medi-Cal Managed Care Adventist Health issued a notice to terminate their contract with Health Plan, effective July 1, 2025. Health Plan is working with Adventist to avoid [...]Read more
Ground Emergency and Non-Emergency Medical Transportation Documentation Requirements
June 9, 2025 / by Health Plan / Alerts
Date: June 06, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Ground Emergency and Non-Emergency Medical Transportation Providers Type: Regulatory Subject: Ground Emergency and Non-Emergency Medical Transportation Documentation Requirements Business: Medi-Cal Managed Care Ground Emergency Medical Transportation and Non-Emergency Medical Transportation Mileage and Address Documentation Requirements Health Plan [...]Read more
Corrected Claim Submissions
June 6, 2025 / by Health Plan / Alerts
Date: June 04, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan All Providers Type: Informational/Educational Subject: Corrected Claim Submissions Business: Medi-Cal Managed Care Corrected Claim Submission Reminder When submitting a correction for a previously submitted claim the following are required: Enter the CLAIM FREQUENCY TYPE as 7, for [...]Read more
HPSJ BHT Referral Process
June 6, 2025 / by Health Plan / Alerts
Date: June 04, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan All BHT/ABA Providers Type: Procedural Update Subject: HPSJ BHT Referral Process Business: Medi-Cal Managed Care Hello ABA Providers, The Behavioral Health Treatment (BHT) team has been working diligently to make the transition from Carelon to Health Plan [...]Read more
Reminder: Mandatory Annual Trainings – Complete by 06/30/2025
June 6, 2025 / by Health Plan / Alerts
Date: June 04, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Practitioners, Hospitals, Facilities, and Staff Type: Regulatory Subject: Reminder: Mandatory Annual Trainings – Complete by 06/30/2025 Business: Medi-Cal Managed Care This is a reminder that the due date is approaching for Health Plan’s mandatory trainings for network [...]Read more