November 8, 2022 / by Health Plan / Alerts
Date: November 8, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Provider Preventable Conditions (PPC) Business: Medi-Cal Managed Care Provider Preventable Conditions (PPC) Reminder Under Section 2702 of the Patient Protection and Affordable Care Act (Pub. L. 111-148) and federal regulations at 42 CFR 447.26, Medi-Cal providers must [...]
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Health Plan of San Joaquin provider Alerts
Immunizations for Adolescents (IMA) Reminder
December 2, 2022 / by Health Plan / Alerts
Date: December 2, 2022 To: HPSJ Contracted Primary Care Providers and Pediatrics From: Health Plan of San Joaquin (HPSJ) Type: Informational/Reminder Subject: Provider Alert Website Correction regarding - Immunizations for Adolescent (IMA) Reminder Business: Medi-Cal Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2022 The following is a reminder regarding the Immunizations for Adolescents (IMA) [...]Read more
Hedis Preseason Reminder for Measurement Year 2022
December 1, 2022 / by Health Plan / Alerts
Date: December 1, 2022 To: HPSJ Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Type: Informational/Educational Subject: HEDIS Preseason Reminder for Measurement Year 2022 Business: Medi-Cal Managed Care REMINDER Healthcare Effectiveness Data and Information Set (HEDIS) Medical Record Review (MRR) season is coming. Medical Record Collection for HEDIS Hybrid measures begins February [...]Read more
Medi-Cal Pharmacy (Rx) Update – Rejection Code 816
December 1, 2022 / by Health Plan / Alerts, Pharmacy Announcements
Date: December 1, 2022 To: Health Plan of San Joaquin (HPSJ) Practitioners and Facilities From: Health Plan of San Joaquin (HPSJ) Type: Informational/Educational Subject: Medi-Cal Pharmacy (Rx) Update – REJECTION CODE 816 Business: Medi-Cal Outpatient pharmacy benefits were transitioned to Medi-Cal Rx on 1-1-2022. Due to the benefit transitioning, some medications are paid for by [...]Read more
Provider Manual Update 45 Day Notice
November 23, 2022 / by Health Plan / Alerts
Date: November 23, 2022 To: HPSJ Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Provider Manual Update 45 Day Notice Business: Medi-Cal Managed Care The following information serves as an official 45-business day notice regarding updates to the Provider Manual. Health Plan of San Joaquin (HPSJ) has updated the Provider Manual [...]Read more
2023 Enhanced Care Management & Community Supports
November 21, 2022 / by Health Plan / Alerts
Date: November 21, 2022 To: HPSJ Primary Care Providers, Specialists, Hospitals and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: 2023 Enhanced Care Management & Community Supports Business: Medi-Cal Managed Care Enhanced Care Management (ECM) and Community Supports (CS) are available for Medi-Cal members in San Joaquin County and Stanislaus County. Starting in 2023, [...]Read more
Reminder – Provider Overpayments
November 18, 2022 / by Health Plan / Alerts
Date: November 18, 2022 To: HPSJ Contracted Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Reminder - Provider Overpayments Business: Medi-Cal Managed Care In accordance with the California Department of Health Care Services (DHCS) All Plan Letters (APLs), 17-003 Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to [...]Read more
Provider Preventable Conditions (PPC)
November 8, 2022 / by Health Plan / Alerts
Date: November 8, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Provider Preventable Conditions (PPC) Business: Medi-Cal Managed Care Provider Preventable Conditions (PPC) Reminder Under Section 2702 of the Patient Protection and Affordable Care Act (Pub. L. 111-148) and federal regulations at 42 CFR 447.26, Medi-Cal providers must [...]Read more
Contraceptive Care (CCP) – Postpartum Women ages 21 to 44 Reminder
November 7, 2022 / by Health Plan / Alerts
Date: November 7, 2022 To: HPSJ Contracted Primary Care Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Contraceptive Care (CCP) - Postpartum Women ages 21 to 44 Reminder Business: Medi-Cal Managed Care Accountability Sets (MCAS) Measure The following is reminder regarding Contraceptive Care (CCP) - Postpartum Women ages 21-44. Description: Women ages [...]Read more
Diabetes Screening for people with schizophrenia or bipolar disorder who are using antipsychotic medication (SSD) Update
November 7, 2022 / by Health Plan / Alerts
Date: November 7, 2022 To: HPSJ Contracted Primary Care Providers and Behavioral Health Providers From: Health Plan of San Joaquin (HPSJ) Subject: Diabetes Screening for people with schizophrenia or bipolar disorder who are using antipsychotic medication (SSD) Update Business: Medi-Cal Managed Care Accountability Sets (MCAS) Measure The following provides an update to the Diabetes Screening [...]Read more
Provider Payment with Change Healthcare – Update
November 4, 2022 / by Health Plan / Alerts
Date: November 4, 2022 To: HPSJ Contracted Providers From: Health Plan of San Joaquin (HPSJ) Subject: Provider Payment with Change Healthcare - Update Business: Medi-Cal Managed Care This is an update that HPSJ will continue with the existing provider payments system. HPSJ strives to offer the best business systems solutions at the highest standards for [...]Read more