September 22, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Date: September 22 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 November 30th, 2021 Business: Medi-Cal Managed Care Effective 11/30/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Eluxadoline (Viberzi) 75 [...]
Read more
Health Plan of San Joaquin provider Alerts
Collecting Social Determinants of Health (SDOH) Data
October 12, 2021 / by Health Plan / Alerts
Date: October 12, 2021 To: Health Plan of San Joaquin (HPSJ) All Practitioners and Facilities From: Health Plan of San Joaquin Subject: Collecting Social Determinants of Health (SDOH) Data Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) has issued APL 21-009 for the purpose of collecting social determinants of health (SDOH) data. [...]Read more
Provider Appointment Availability Survey – IT IS HERE!
October 11, 2021 / by Health Plan / Alerts
Date: October 11, 2021 To: Health Plan of San Joaquin Contracted Provider Network From: Health Plan of San Joaquin Subject: Provider Appointment Availability Survey – IT IS HERE! Business: Medi-Cal Managed Care HPSJ is required by the California Department of ManagedHealthCare (DMHC) to perform an annual Provider Appointment Availability Survey (PAAS). The first wave of [...]Read more
UPDATE: Fee-For-Service (FFS) Payments
October 4, 2021 / by Health Plan / Alerts
Date: October 4, 2021 To: Health Plan of San Joaquin (HPSJ) All Contracted Providers From: Health Plan of San Joaquin Subject: UPDATE: Fee-For-Service (FFS) Payments Business: Medi-Cal Managed Care Due to the timing of receipt of the monthly eligibility file from the Department of Health Care Services (DHCS), there may be a delay in the [...]Read more
Formulary Update – Effective November 30th, 2021
September 22, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Date: September 22 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 November 30th, 2021 Business: Medi-Cal Managed Care Effective 11/30/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Eluxadoline (Viberzi) 75 [...]Read more
Reminder: Immunization follow up should be conducted by age 2
September 22, 2021 / by Health Plan / Alerts
Date: September 22, 2021 To: Health Plan of San Joaquin (HPSJ) Contracted PCPs, Clinics, Pediatrics Offices From: Health Plan of San Joaquin Subject: Child Immunization Status UPDATE – Reminder: Immunization follow up should be conducted by age 2 Business: Medi-Cal Managed Care SUMMARY FOR MEASURE YEAR (MY) 2021 Childhood Immunization Status: Combination 10 Providers, please [...]Read more
Pain management network updates
September 20, 2021 / by Health Plan / Alerts
In recent months, there have been several changes to Health Plan of San Joaquin’s (HPSJ) contracted Pain Management network. Please see the list of providers below that are accepting new patients currently. For a full list of all contracted pain management providers, visit the Doctors Referral Express (DRE) Provider Portal; located at https://www.hpsj.com/find-a-doctor/ or please […]
Read more
HPSJ Members – myRewards Postcard Reminders
September 8, 2021 / by Health Plan / Alerts
Date: September 8, 2021 To: Health Plan of San Joaquin (HPSJ) CONTRACTED Providers From: Health Plan of San Joaquin Subject: HPSJ Members – myRewards Postcard Reminders Business: Medi-Cal Managed Care HPSJ myRewards Program Incentives for Members – Closing Gaps in Care, Improving HEDIS rates Since August, Health Plan of San Joaquin patients began receiving myRewards [...]Read more
REMINDER: MANDATORY– Cultural Competency Training2021
September 7, 2021 / by Health Plan / Alerts
Date: September 7, 2021 To: Health Plan of San Joaquin (HPSJ) Providers From: Health Plan of San Joaquin Subject: REMINDER: MANDATORY– Cultural Competency Training 2021 Business: Medi-Cal Annual Training Requirement ACTION REQUIRED Annual training is mandated by California’s Department of Health Care Services (DHCS) and the federal Centers for Medicare and Medicaid Services (CMS) to [...]Read more
REMINDER: MANDATORY Fraud, Waste and Abuse (FWA) Training 2021
September 7, 2021 / by Health Plan / Alerts
Date: September 7, 2021 To: Health Plan of San Joaquin (HPSJ) Providers From: Health Plan of San Joaquin Subject: REMINDER: MANDATORY Fraud, Waste and Abuse (FWA) Training 2021 Business: Medi-Cal Annual Training Requirement ACTION REQUIRED Annual Fraud, Waste and Abuse (FWA) training for ALL PROVIDERS Each year, all providers are required to complete FWA training [...]Read more
UPDATE: Monthly Capitation (CAP) Payments
September 1, 2021 / by Health Plan / Alerts
Date: September 1, 2021 To: Health Plan of San Joaquin (HPSJ) All Contracted From: Health Plan of San Joaquin Subject: UPDATE: Monthly Capitation (CAP) Payments Business: Medi-Cal Managed Care Due to the Labor Day holiday, there may be a delay in the normal delivery schedule for your monthly CAP payment. We want you to be [...]Read more