February 13, 2020 / by HPSJ / Alerts, Pharmacy Announcements
Date: February 13, 2020 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update Business: Medi-Cal Effective 04/20/2020, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Phentermine (Adipex-P) 15mg, 30mg, 37.5mg capsule: No restrictions. Nateglinide […]
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Health Plan of San Joaquin provider Alerts
Reminders for COVID-19 (Coronavirus) HPSJ Member Care
March 10, 2020 / by HPSJ / Alerts
Date: March 10, 2020 To: Health Plan of San Joaquin (HPSJ) Providers, Practices, and Facilities From: HPSJ Provider Services Department Subject: Reminders for COVID-19 (Coronavirus) HPSJ Member Care Business: Medi-Cal Like you, Health Plan of San Joaquin (HPSJ) is closely following all the advisories from the CDC and the California Department of Public Health, as […]
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Provider Incentive Claims Timeline
March 9, 2020 / by HPSJ / Alerts
Date: February 21, 2018 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers From: HPSJ Pharmacy Department Subject: Provider Incentive Claims Timeline Business: Medi-Cal Date for claims to be received by HPSJ HPSJ is reviewing the data for HEDIS 2017. We will soon send the final claims data for Calendar Year 2017 for processing. […]
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Phenytoin 125mg/5ml suspension Recall
March 6, 2020 / by HPSJ / Alerts, Pharmacy Announcements
Date: March 6, 2020 To: Health Plan of San Joaquin (HPSJ) Pharmacies From: HPSJ Pharmacy Department Subject: Phenytoin 125mg/5ml suspension Recall Business: Medi-Cal We are sending this alert because your patients may have filled a prescription for Phenytoin 125mg/5ml suspension within the last six months (180 days). The reason for the recall is that product […]
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Good News – Additional supports for your HPSJ patient – myRewards, Texting Pilot Program
March 3, 2020 / by HPSJ / Alerts
Date: March 3, 2020 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: HPSJ Quality Management Department Subject: Good News – Additional supports for your HPSJ patients MyRewards, Revised for Member Incentives Texting Pilot Program, prompts for members to act for preventative health Business: Medi-Cal Managed Care Visit this section to learn [...]Read more
Update – Possible Fraud, Waste and/or Abuse (76811 vs 76805)
March 2, 2020 / by HPSJ / Alerts
Date: January 10, 2020 To: Health Plan of San Joaquin (HPSJ) OB/GYN Offices/Groups, Clinics, and FQHC’s From: HPSJ Claims Department Subject: Update – Possible Fraud, Waste and/or Abuse (76811 vs 76805) CPT Code 76811, Detailed Fetal Anatomic Ultrasound CPT Code 76805, Complete OB Ultrasound Business: Medi-Cal Managed Care In accordance with the California’s Department of […]
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Cost Avoidance and Post-Pay Recoveries – Coming DHCS Intervention
March 2, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: March 2, 2020 To: Health Plan of San Joaquin (HPSJ) All Practitioners and Facilities From: HPSJ Claims Department Subject: Cost Avoidance and Post-Pay Recoveries – Coming DHCS Intervention Business: Medi-Cal Managed Care State Law requires Medi-Cal and Managed Care Plans (MCP’s) to be the payer of last resort for services in which there is […]
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Formulary Update Effective 4/20/2020
February 13, 2020 / by HPSJ / Alerts, Pharmacy Announcements
Date: February 13, 2020 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update Business: Medi-Cal Effective 04/20/2020, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Phentermine (Adipex-P) 15mg, 30mg, 37.5mg capsule: No restrictions. Nateglinide […]
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HEDIS: Annual Medical Records Review
February 7, 2020 / by HPSJ / Alerts
Date: January 31, 2020 To: Health Plan of San Joaquin (HPSJ) Providers From: Medical Management Department – Health Plan of San Joaquin Subject: HEDIS: Annual Medical Records Review Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) HPSJ Quality Management Department is preparing to launch the 2020 NCQA HEDIS Survey and Medical Record Review […]
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African American Mental Health Providers Support Group
January 28, 2020 / by HPSJ / Alerts
Date: January 28, 2020 To: Health Plan of San Joaquin (HPSJ) Behavioral Health Providers From: HPSJ Health Education Department Subject: African American Mental Health Providers Support Group Business: Medi-Cal Ayesha Paige Hunter, EdD, LMFT, is a provider who sits on the Perinatal Equity Initiative Community Advisory Board group (PEI CAB). Dr. Hunter has organized a […]
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Notice of Recoupment- Capitation (CAP) Overpayment – Unallowed payments – CAP paid providers after HSPJ members’ death
January 10, 2020 / by HPSJ / Alerts
Date: January 10, 2020 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, Pharmacies, and Capitated Service Providers From: Health Plan of San Joaquin Subject: Notice of Recoupment – Capitation (CAP) Overpayment – Unallowed payments – CAP paid providers after Health Plan of San Joaquin members’ death Business: Medi-Cal Dear Provider, We have been informed […]
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