Health Plan of San Joaquin provider Alerts

Update – Grievance Process

Date: June 4, 2021 To: Health Plan of San Joaquin Contracted Practitioners, Providers & Facilities From: Health Plan of San Joaquin Subject: Update – Grievance Process Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) require Health Plan of San Joaquin (HPSJ) to monitor and [...]

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HEDIS season 2021 Audit Completed

Date: May 25, 2021 To: Health Plan of San Joaquin (HPSJ) CONTRACTED PROVIDERS From: Health Plan of San Joaquin Subject: HEDIS season 2021 Audit Completed Business: Medi-Cal The HEDIS team in the Quality Department of Health Plan of San Joaquin (HPSJ) would like to thank you for your efforts and delivery of medical records during [...]

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UPDATE Value Based Payment (VBP) Program

Date: May 18, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: ~UPDATE~ Value Based Payment (VBP) Program Business: Medi-Cal Managed Care The following is an update for the Value Based Payment (VBP) Program operations. HPSJ is in the process of implementing a technical update to our [...]

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Claims Look-Up Tool – For Non-Contracted Providers

Date: May 18, 2021 To: Health Plan of San Joaquin (HPSJ) Contracted and Non-Contracted Providers From: Health Plan of San Joaquin Subject: Claims Look-Up Tool – For Non-Contracted Providers Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) has a helpful tool, outside of the provider portal, for contracted and non-contracted providers to track [...]

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Formulary Update – Effective 07/19/2021

Date: May 13, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update - Effective 07/19/2021 Business: Medi-Cal Effective 07/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Teprotumumab (Tepezza) 500mg vial: Reserved for [...]

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UPDATE– DHCS Guidance – COVID-19 Vaccines & Vaccination Administration

Date: May 5, 2021 To: Health Plan of San Joaquin (HPSJ) Providers and Pharmacists From: Health Plan of San Joaquin Subject: UPDATE– DHCS Guidance – COVID-19 Vaccines & Vaccination Administration Business: Medi-Cal Managed Care The California Department of Health Care Services (DHCS) has now issued updated guidance for all Medi-Cal managed care health care plans [...]

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REMINDER and SUPPORT FROM HPSJ – Prior Authorization (PA) | National Drug Codes (NDC) | Other Health Coverage (OHC)

Date: April 20, 2021 To: Health Plan of San Joaquin (HPSJ) Oncology Providers From: Health Plan of San Joaquin  Subject: REMINDER and SUPPORT FROM HPSJ - Prior Authorization (PA) | National Drug Codes (NDC) | Other Health Coverage (OHC) Business: Medi-Cal Managed Care To support you in becoming familiar with regulatory requirements and help your [...]

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Formulary Update – FORA V30 Meters are replaced with FORA Premium V10 Meters

Date: April 19, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Subject: Formulary Update – FORA V30 Meters are replaced with FORA Premium V10 Meters Business: Medi-Cal The FORA V30a Blood Glucose Monitors are being discontinued by the manufacturer. Therefore, they will be replaced with [...]

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