Health Plan of San Joaquin provider Alerts

Behavioral Health Treatment

As of September 15, 2014, Medi-Cal plans are responsible for providing Behavioral Health Therapy (BHT) services to individuals under the age of 21 who have an Autism Spectrum Disorder (ASD) diagnosis and for individuals without a diagnosis of autism where medically indicated. The Health Plan of San Joaquin’s Behavioral Health Benefits Manager, Beacon Health Strategies […]

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Introducing EFT Payment!

Health Plan of San Joaquin has selected Emdeon as its electronic payment and remittance reporting provider. There is no cost to you to use Emdeon ePayment and enrollment is free! Emdeon ePayment Replaces paper-based claims payments with electronic (EFT) payments that are directly deposited into your bank account Benefits of Emdeon ePayment Helps You Get […]

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HPSJ 2014 Holiday Service Hours

December 24, 2014 Provider Alert To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Provider Relations Department Subject: Holiday Service Hours Products: All Health Plan of San Joaquin and San Joaquin Health Administrators will be closed as follows: Wednesday, December 24, 2014  Closed 3:00pm – 5:00pm Thursday, December 25, 2014  Closed Thursday, January […]

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Introducing the new Health Plan of San Joaquin Website

To:                   All Providers From:             Health Plan of San Joaquin Subject:         New HPSJ Website Products:      Medi-Cal Managed Care Introducing the new Health Plan of San Joaquin Website Health Plan of San Joaquin is excited to announce the launch of our newly designed website, hpsj4.wpengine.com, set to go live on Monday, December 22, 2014. Our goal was […]

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New Prior Authorization Form

December 1, 2014 PROVIDER ALERT To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy Department Subject: New Prior Authorization Form Required effective 1/1/2015 Products: All Senate Bill (SB) 866 will become effective for DMHC regulated Health Plans (including HPSJ) on January 1st, 2015. This law requires […]

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Recommendations For Synagis 2014-2015

RECOMMENDATIONS FOR SYNAGIS 2014-2015 CPT Code 96372 The American Academy of Pediatrics (AAP) recommends the use of palivizumab (Synagis), an RSV monoclonal antibody vaccine, to prevent serious RSV illness in qualifying high-risk infants. The 2014 AAP recommendations (Red Book 29th edition) as well as the 2014 CCS Synagis Guidelines (NL: 13-0914) are incorporated into the […]

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Annual Access Study

November 21, 2014 PROVIDER ALERT To: Primary Care Providers (PCP) and Specialists From: Quality Management Department Subject: Annual Access Study Products: Medi-Cal The California Department of Managed Health Care requires health plans to establish metrics for measuring and monitoring the adequacy of a health plan’s contracted provider network to provide enrollees with timely access to […]

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ACA Section 1202 Payment – 10/29/2014

October 21, 2014 ACA Section 1202 Payment Provider Alert To: HPSJ Providers (Excluding Federally Qualified Health Clinics (FQHC) and Rural Health Clinics (RHCs) From: Provider Relations Department Pursuant to the Affordable Care Act (ACA) as amended by the H.R. 4872-24 Health Care and Education Reconciliation Act of 2010, Section 1202, ACA and 42 Code of […]

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PCP Assignments for Duals – 10/24/2014

PCP Assignments for HPSJ Members with Dual Coverage To: Health Plan of San Joaquin Providers From: Provider Services Department Product: Medicare/Medi-Cal Program Effective October 1, 2014, HPSJ members’ covered by Medicare Part B or Medicare Part A & B will not have an HPSJ primary care provider designated. ID cards issued after October 15th will […]

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Formulary Update HPSJ -10/21/2014

To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Date: September 16, 2014 Subject: Formulary status changes Products: Medi-Cal, AIM Formulary Update Effective 9/16/2014, the Pharmacy and Therapeutics Committee has approved the following changes. Formulary Status Changes: Rabeprazole (Aciphex) – Prior authorization (PA) required. […]

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