June 14, 2024 / by Health Plan / Alerts
Date: June 13, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Hospitals Type: Regulatory Subject: Injections- Hydration Business: Medi-Cal Managed Care Through the new Claims Editing System (CES), Health Plan has identified the most significant changes and would like to share those with you. Medi-Cal policies [...]
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Health Plan of San Joaquin provider Alerts
Laboratory Test in Hospital and Pathology Billing – Update
June 20, 2024 / by Health Plan / Alerts
Date: June 19, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan) Pathologist/Laboratory Providers & Inpatient/Outpatient Facilities Type: Regulatory Subject: Laboratory Test in Hospital and Pathology Billing - Update Business: Medi-Cal Managed Care Please review the following California Medicaid (MCL) billing guidelines for proper claim submission and reimbursement for pathology [...]Read more
Billing Anesthesia Services
June 20, 2024 / by Health Plan / Alerts
Date: June 19, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan) Practitioners and Hospitals Type: Regulatory Subject: Billing Anesthesia Services Business: Medi-Cal Managed Care Billing Anesthesia Services Anesthesia services (CPT codes 00100 through 01999) are reimbursed when medically necessary. To bill for anesthesia services, use the five-digit [...]Read more
Final Reminder: CalAIM All-Network Training
June 20, 2024 / by Health Plan / Alerts
Date: June 19, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: El Dorado and Alpine County Providers Type: Informational/ Educational Subject: Final Reminder: CalAIM All-Network Training Business: Medi-Cal Managed Care This alert is a reminder. Please join us for a CalAIM All-Network Training on the date listed below. Health Plan [...]Read more
The Department of Healthcare Services Skilled Nursing Facilities Workforce & Quality Improvement Program- Update
June 14, 2024 / by Health Plan / Alerts
Date: June 13, 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 & Quality Improvement Program- Update Business: Medi-Cal Managed Care The Department of Healthcare Services (DHCS) Skilled Nursing Facilities (SNF) Workforce & [...]Read more
DRE Remittance Advice Tool – Reminder
June 14, 2024 / by Health Plan / Alerts
Date: June 13, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: DRE Remittance Advice Tool - Reminder Business: Medi-Cal Managed Care As a reminder, all providers have the ability to access their payment details through the Remittance Advice (RA) tool via the provider [...]Read more
Injections- Hydration
June 14, 2024 / by Health Plan / Alerts
Date: June 13, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Hospitals Type: Regulatory Subject: Injections- Hydration Business: Medi-Cal Managed Care Through the new Claims Editing System (CES), Health Plan has identified the most significant changes and would like to share those with you. Medi-Cal policies [...]Read more
Retrospective Review Process- Update
June 7, 2024 / by Health Plan / Alerts
Date: June 05, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners and Facilities Type: Informational/Educational Subject: Retrospective Review Process- Update Business: Medi-Cal Managed Care Effective January 1, 2024, DHCS requires all Managed Care Plans to have a retrospective review process that allows providers to submit requests for [...]Read more
Reminder: CalAIM All-Network Training
June 7, 2024 / by Health Plan / Alerts
Date: June 05, 2024 From: Health Plan To: El Dorado and Alpine County Providers Type: Informational/Educational Subject: Reminder: CalAIM All-Network Training Business: Medi-Cal Managed Care This alert is a reminder. Please join us for a CalAIM All-Network Training on the date listed below. Health Plan will be co-facilitating a presentation with partnering Managed Care Plans [...]Read more
Reminder: Mandatory Annual Trainings – Complete by 06/30/2024
June 7, 2024 / by Health Plan / Alerts
Date: June 05, 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
Incontinence Medical Supply Billing Requirements
June 5, 2024 / by Health Plan / Alerts
Date: June 05, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Durable Medical Equipment (DME) and Medical Supply Providers Type: Regulatory Subject: Incontinence Medical Supply Billing Requirements Business: Medi-Cal Managed Care Through the new Claims Editing System (CES), Health Plan has identified when billing Incontinence Medical Supplies the secondary diagnosis is [...]Read more