Health Plan of San Joaquin provider Alerts

DHCS Encounter Requirements – Date Validation

Date: March 23, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: DHCS Encounter Requirements – Date Validation Business: Medi-Cal Managed Care HPSJ has implemented several new claim denials if claims are not submitted with the required information. This is part of Health Plan of [...]

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20 Myth Busters: COVID-19 Vaccinations

Date: March 22, 2021 To: HPSJ Providers From: Health Plan of San Joaquin Subject: 20 Myth Busters: COVID-19 Vaccinations Business: Medi-Cal As the roll-out of COVID-19 vaccinations continues, we know you have questions. And we know you continue to appreciate more vaccination information while you work to support your patients, as well as our community. [...]

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COMING SOON: Enhanced Provider Dispute Resolution (PDR) Process

Date: March 10, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: COMING SOON: Enhanced Provider Dispute Resolution (PDR) Process Business: Medi-Cal Managed Care As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each Provider Dispute Resolution (PDR) is appropriately routed [...]

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Claims Corner Spotlights – March 2021

COVID-19 Resources for Providers – hpsj.com/covid-19-provider-information/ Virtual Briefing on Vaccinations (2/17/21) HPSJ Claims Director Terry Cumpian joined San Joaquin and Stanislaus County Health Officers, and host HPSJ Chief Medical Officer Dr. Lakshmi Dhanvanthari, for this event. SEE the recorded event video. DOWNLOAD the slides from county health officers Dr. Maggie Park and Dr. Julie Vaishampayan. [...]

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Proprietary Laboratory Analyses (PLA) Codes

Date: February 26, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: Proprietary Laboratory Analyses (PLA) Codes Business: Medi-Cal Managed Care In an ongoing effort to keep our Providers informed of upcoming changes, HPSJ would like to take this opportunity to provide an update regarding PLA codes. [...]

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Information found on the HPSJ Website

Date: February 25, 2021 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP), OBGYN and All Specialist From: Health Plan of San Joaquin Subject: Information found on the Website Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) would like to remind you about our website http://www.hpsj.com. We include information about many [...]

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Leading Screening – Children

Date: February 25, 2021 To: Health Plan of San Joaquin (HPSJ Providers From: Health Plan of San Joaquin Subject: Leading Screening - Children Business: Medi-Cal Childhood Blood Screenings Noted: Gaps for your HPSJ patients Federal & Quality Measure Requirements In 2021, HPSJ will send quarterly communications to your office highlighting the list of members who [...]

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Formulary updates effective for April 19, 2021

Date: February 22, 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 Business: Medi-Cal Effective 04/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Sodium Ferric Gluconate/Sucrose (Ferrlecit) 62.5mg/5ml vial: No restrictions. Ferumoxytol [...]

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TOP TOPICS Monthly Spotlights Just for HPSJ Providers, February 19, 2021

Virtual Briefing COVID-19 Vaccinations Virtual Briefing COVID-19 Vaccinations February 17 (6-7PM) hosted by HPSJ for ALL Providers Maggie Park, MD, San Joaquin County Public Health Officer Julie Vaishampayan, MD, MPH, FIDSA, Stanislaus County Public Health Officer Introductions Lakshmi Dhanvanthari, MD HPSJ Chief Medical Officer How to Bill for Administering Vaccines Terry Cumpian HPSJ Claims Director [...]

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Updated Provider Manual to Reflect Current Standards and Guidelines

Date: Health Plan of San Joaquin (HPSJ) Providers To: February 11, 2021 From: Health Plan of San Joaquin Subject: Updated Provider Manual to Reflect Current Standards and Guidelines Business: Medi-Cal Attn: Office Administrator Dear Provider, This letter is to serve as an official 45-day notice that in order to meet California Department of Managed Health [...]

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