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 [...]
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Health Plan of San Joaquin provider Alerts
Contraceptive Care (CCW–AD) All Women Ages 21 to 44 Reminder
November 4, 2022 / by Health Plan / Alerts
Date: November 4, 2022 To: HPSJ Contracted Primary Care Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Contraceptive Care (CCW–AD) All Women Ages 21 to 44 Reminder Business: Medi-Cal Managed Care Accountability Sets (MCAS) Measure The following is a reminder regarding the Contraceptive Care (CCW – AD). Description The percentage of women ages [...]Read more
Well Child Visits in the First 30 Months of Life (W30) Update
November 4, 2022 / by Health Plan / Alerts
Date: November 4, 2022 To: HSPJ Contracted Primary Care Providers and Pediatrics From: Health Plan of San Joaquin (HPSJ) Subject: Well Child Visits in the First 30 Months of Life (W30) Update Business: Medi-Cal Managed Care Accountability Sets (MCAS) Measure The following is a update regarding the Well Child Visits in the First 30 Months [...]Read more
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