August 31, 2020 / by HPSJ / Alerts, Pharmacy Announcements
Date: August 31, 2020 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Subject: Pharmacy Update: Oncology Medicine Business: Medi-Cal Effective 11/2/2020, all oncology medications will require prior authorizations. Please note that the following list of the medications is not all inclusive. Download the Oncology Medicine PDF [...]
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Health Plan of San Joaquin provider Alerts
Clinical Review: 2020 Standards of Care for Treatment of Type 2 Diabetes
September 2, 2020 / by HPSJ / Alerts, Pharmacy Announcements
Learning Objectives: Review recommendations provided in the American Diabetes Association (ADA) Standards of Medical Care – 2020 addressing the pharmacologic approach to glycemic control for patients with type 2 diabetes Describe patient factors to consider when prescribing antihyperglycemic agents Understand the boxed warnings for antihyperglycemic agents Download the full documente here: Key Points: Diabetes is […]
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Requirements – Office Closure/Re-Opening Notifications
September 1, 2020 / by HPSJ / Alerts
Date: September 1, 2020 To: HPSJ Providers, Practices (PCPs & Specialists), Hospitals & Ancillary Facilities From: Health Plan of San Joaquin Subject: Requirements – Office Closure/Re-Opening Notifications Business: Medi-Cal We are intensely aware of the difficult position medical offices are enduring, as each takes steps to keep their teams and patients safe. Each day HPSJ [...]Read more
COVID-19: Overpayments on Testing Codes
August 31, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: August 31, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: COVID-19: Overpayments on Testing Codes Business: Medi-Cal In response to the Novel Coronavirus (COVID-19), the Centers for Medicare & Medicaid Services (CMS) established the following HCPCS codes for COVID-19 diagnostic testing services: U0003: [...]Read more
Pharmacy Update: Oncology Medicine
August 31, 2020 / by HPSJ / Alerts, Pharmacy Announcements
Date: August 31, 2020 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Subject: Pharmacy Update: Oncology Medicine Business: Medi-Cal Effective 11/2/2020, all oncology medications will require prior authorizations. Please note that the following list of the medications is not all inclusive. Download the Oncology Medicine PDF [...]Read more
MCAS Measure AMM – Antidepressant Medication Management
August 27, 2020 / by HPSJ / Alerts
Date: August 27, 202 0 To: HPSJ Primary Care Providers {PCP} and Behavioral Health Care Providers From: HPSJ Quality Management Department Subject: MCAS Measure AMM – Antidepressant Medication Management Business: Medi-Cal The HPSJ Quality Team looks at adults ages 18+ who have a diagnosis of major depression and have been subsequently prescribed antidepressants. When documenting [...]Read more
DMHC/DHCS Timely Access Standards + Wait Times Set/Monitored by HPSJ
August 26, 2020 / by HPSJ / Alerts
Date: August 26, 2020 To: HPSJ Quality Management Department From: HPSJ Quality Management Department Subject: DMHC/DHCS Timely Access Standards + Wait Times Set/Monitored by HPSJ Business: Medi-Cal Health Plan of San Joaquin (HPSJ) is charged with maintaining the quality of care for our members. As such we must monitor access and availability within the network, [...]Read more
A virtual training session for HEDIS/NCQA Quality Measures 2020-2021
August 21, 2020 / by HPSJ / Alerts
Join us for your 2020 Vision of HPSJ’s LOOK and LEARN! (A virtual training session for HEDIS/NCQA Quality Measures 2020-2021). Let HPSJ help you and your staff increase quality standards! If your practice is focused on delivering quality services and interested in increasing your earning potential, we encourage you to register for one of the [...]Read more
Proposition 56 Funded ‐ Value Based Payment (VBP) program
August 19, 2020 / by HPSJ / Alerts
Date: August 19, 2020 To: Health Plan of San Joaquin (HPSJ) Contracted Physicians From: HPSJ Claims Department Subject: Proposition 56 Funded ‐ Value Based Payment (VBP) program – Updates for 8/2020 Business: Medi-Cal Health Plan of San Joaquin (HPSJ) is working diligently to implement the supplemental payments for the Department of Health Care Services (DHCS) […]
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DHCS Encounter Requirements – Patient Reason DX
July 16, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: July 16, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: DHCS Encounter Requirements – Patient Reason DX Business: Medi-Cal As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each claim submission will reconcile with each encounter submission to the California’s Department […]
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DHCS Encounter Requirements – Claim submissions
July 16, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: July 16, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: DHCS Encounter Requirements – Claim submissions Business: Medi-Cal As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each claim submission will reconcile with each encounter submission to the California’s Department of […]
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