October 21, 2022 / by Health Plan / Alerts
Date: October 18, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Virtual Look and Learn Business: Medi-Cal Managed Care Please join us October 19, 2022, from 12:00 pm to 1:00 pm, for a Virtual Provider Look and Learn Session. We will be covering the following items: Breast Cancer [...]
Read more
Health Plan of San Joaquin provider Alerts
Childhood Immunization Status (CIS) Reminder
November 3, 2022 / by Health Plan / Alerts
Date: November 3, 2022 To: HPSJ Contracted PCP’s & Pediatrics From: Health Plan of San Joaquin (HPSJ) Subject: Childhood Immunization Status (CIS) Reminder Business: Medi-Cal Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2022 The following is a reminder regarding the Childhood Immunizations Status (CIS) Combo-10. Description Vaccination must occur on or before child’s [...]Read more
Provider Satisfaction Survey – Starting November 18, 2022
November 2, 2022 / by Health Plan / Alerts
Date: November 2, 2022 To: HPSJ Contracted Provider Network From: Health Plan of San Joaquin (HPSJ) Subject: Provider Satisfaction Survey – Starting November 18, 2022 Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) conducts an annual Provider Satisfaction Survey of its contracted providers to capture their rate of satisfaction with HPSJ. Information obtained [...]Read more
After Hours Survey – Starting November 14, 2022
November 2, 2022 / by Health Plan / Alerts
Date: November 2, 2022 To: HPSJ Contracted Provider Network From: Health Plan of San Joaquin (HPSJ) Subject: After Hours Survey – Starting November 14, 2022 Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) monitors after-hours access for our members on an ongoing basis, as required by the Department of Health Care Services (DHCS) [...]Read more
APL 21-015 Mandatory Managed Care Enrollment (MMCE) Transition Phase II
November 2, 2022 / by Health Plan / Alerts
Date: November 2, 2022 To: HPSJ Primary Care Providers, Specialists, Hospitals and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: APL 21-015 Mandatory Managed Care Enrollment (MMCE) Transition Phase II Business: Medi-Cal Managed Care As part of CalAIM, mandatory managed care enrollment (MMCE) aims to enhance coordination of care, increase standardization, and reduce complexity [...]Read more
Reminder: Coming January 2023 Skilled Nursing Facilities – Long Term Care (LTC) Benefit Transitioning to Medi-Cal Managed Care Health Plans
November 1, 2022 / by Health Plan / Alerts
Date: November 1, 2022 To: HPSJ Contracted Providers From: Health Plan of San Joaquin (HPSJ) Subject: Reminder: Coming January 2023 Skilled Nursing Facilities - Long Term Care (LTC) Benefit Transitioning to Medi-Cal Managed Care Health Plans Business: Medi-Cal Managed Care As part of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including the mandatory transition [...]Read more
Grievance Process
October 31, 2022 / by Health Plan / Alerts
Date: October 31, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Grievance Process Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) requires Health Plan of San Joaquin (HPSJ) to monitor and investigate all member complaints regarding their [...]Read more
Balance Billing is Prohibited
October 28, 2022 / by Health Plan / Alerts
Date: October 27, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Balance Billing is Prohibited Business: Medi-Cal Managed Care This alert serves as a reminder to all Health Plan of San Joaquin (HPSJ) providers that balance billing Medi-Cal members is prohibited by federal and state law. Medi-Cal members [...]Read more
Childhood Lead Screening (LSC)- 2022 HEDIS Measure Update
October 28, 2022 / by Health Plan / Alerts
Date: October 27, 2022 To: HPSJ Contracted Primary Care Providers & Pediatrics From: Health Plan of San Joaquin (HPSJ) Subject: Childhood Lead Screening (LSC)- 2022 HEDIS Measure Update Business: Medi-Cal Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2022-(LSC) Update The following is an update to the provider alert you received in July 2022, [...]Read more
APL 22-014 Electronic Visit Verification Implementation Requirements
October 21, 2022 / by Health Plan / Alerts
Date: October 20, 2022 To: Personal Care Services (PCS) and Home Health Care Services (HHCS) Providers From: Health Plan of San Joaquin (HPSJ) Subject: APL 22-014 Electronic Visit Verification Implementation Requirements Business: Medi-Cal Managed Care All Plan Letter 22-014 was released to provide guidance regarding the implementation of federally mandated Electronic Visit Verification (EVV) requirements. [...]Read more
Virtual Look and Learn
October 21, 2022 / by Health Plan / Alerts
Date: October 18, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Virtual Look and Learn Business: Medi-Cal Managed Care Please join us October 19, 2022, from 12:00 pm to 1:00 pm, for a Virtual Provider Look and Learn Session. We will be covering the following items: Breast Cancer [...]Read more