June 20, 2025 / by Health Plan / Alerts
Date: June 18, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Primary Care Physicians, Obstetricians, Pediatricians, and Federally Qualified Health Centers Type: Informational Subject: MyRewards Member Incentive Update Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ)/Mountain Valley Health Plan (MVHP) is enhancing its member incentive program to [...]
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Health Plan of San Joaquin provider Alerts
Medical Benefit Update – Effective September 8, 2025
July 2, 2025 / by Health Plan / Alerts
Date: July 02, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Pharmacy and Therapeutics Committee To: Health Plan Practitioners and Facilities Type: Formulary Subject: Medical Benefit Update – Effective September 8, 2025 Business: Medi-Cal Managed Care Effective September 8, 2025, the Pharmacy and Therapeutics Committee has approved the following changes to [...]Read more
2025 California Child & Family Services Conference
July 2, 2025 / by Health Plan / Alerts
Date: July 02, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan All Providers Type: Event Subject: 2025 California Child & Family Services Conference Business: Medi-Cal Managed Care The California Alliance of Child and Family Services is hosting a 2025 California Child & Family Services Conference, taking place September [...]Read more
Adventist Health Contract Renewal Agreement
June 30, 2025 / by Health Plan / Alerts
Date: June 27, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Facilities and Hospitals Type: Informational Subject: Adventist Health Contract Renewal Agreement Business: Medi-Cal Managed Care Health Plan has good news to share. Adventist Health will not terminate their hospital and provider groups contracts on July 1, 2025, [...]Read more
Claims Processing System Upgrade – QNXT 2.0 Go-Live 7/25/2025
June 26, 2025 / by Health Plan / Alerts
Date: June 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Facilities and Hospitals Type: Informational Subject: Claims Processing System Upgrade - QNXT 2.0 Go-Live 7/25/2025 Business: Medi-Cal Managed Care Health Plan is proud to announce that our current claims processing system will be upgraded to QNXT 2.0, [...]Read more
Behavioral Health Provider Credentialing
June 26, 2025 / by Health Plan / Alerts
Date: June 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Applied Behavior Analysis (ABA) Providers Type: Procedural Update Subject: Behavioral Health Provider Credentialing Business: Medi-Cal Managed Care As of May 1st, 2025, Health Plan started credentialing Board Certified Behavioral Analyst (BCBA) providers, to be in compliance with [...]Read more
Jiva System Upgrade
June 26, 2025 / by Health Plan / Alerts
Date: June 25, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers Type: Informational Subject: Jiva System Upgrade Business: Medi-Cal Managed Care Health Plan's medical management system, Jiva, will be temporarily down for an upgrade. The upgrade is planned for this weekend and will support additional functionality. During [...]Read more
2025 Subacute Care Program Updates
June 20, 2025 / by Health Plan / Alerts
Date: June 18, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Skilled Nursing Facilities and Long-Term Care Type: Informational/Educational Subject: 2025 Subacute Care Program Updates Business: Medi-Cal Managed Care The Health Plan would like to share additional guidance related to the Subacute Care Program to support accurate billing [...]Read more
MyRewards Member Incentive Update
June 20, 2025 / by Health Plan / Alerts
Date: June 18, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Primary Care Physicians, Obstetricians, Pediatricians, and Federally Qualified Health Centers Type: Informational Subject: MyRewards Member Incentive Update Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ)/Mountain Valley Health Plan (MVHP) is enhancing its member incentive program to [...]Read more
Adventist Health Termination
June 12, 2025 / by Health Plan / Alerts
Date: June 11, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Facilities and Hospitals Type: Informational Subject: Adventist Health Termination Business: Medi-Cal Managed Care Adventist Health issued a notice to terminate their contract with Health Plan, effective July 1, 2025. Health Plan is working with Adventist to avoid [...]Read more
Ground Emergency and Non-Emergency Medical Transportation Documentation Requirements
June 9, 2025 / by Health Plan / Alerts
Date: June 06, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Ground Emergency and Non-Emergency Medical Transportation Providers Type: Regulatory Subject: Ground Emergency and Non-Emergency Medical Transportation Documentation Requirements Business: Medi-Cal Managed Care Ground Emergency Medical Transportation and Non-Emergency Medical Transportation Mileage and Address Documentation Requirements Health Plan [...]Read more