October 21, 2022 / by Health Plan / Alerts
Date: October 18, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Virtual Look and Learn Business: Medi-Cal Managed Care Please join us October 19, 2022, from 12:00 pm to 1:00 pm, for a Virtual Provider Look and Learn Session. We will be covering the following items: Breast Cancer [...]
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Health Plan of San Joaquin provider Alerts
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
APL 22-014 Electronic Visit Verification Implementation Requirements
October 21, 2022 / by Health Plan / Alerts
Date: October 20, 2022 To: Personal Care Services (PCS) and Home Health Care Services (HHCS) Providers From: Health Plan of San Joaquin (HPSJ) Subject: APL 22-014 Electronic Visit Verification Implementation Requirements Business: Medi-Cal Managed Care All Plan Letter 22-014 was released to provide guidance regarding the implementation of federally mandated Electronic Visit Verification (EVV) requirements. [...]Read more
Virtual Look and Learn
October 21, 2022 / by Health Plan / Alerts
Date: October 18, 2022 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Virtual Look and Learn Business: Medi-Cal Managed Care Please join us October 19, 2022, from 12:00 pm to 1:00 pm, for a Virtual Provider Look and Learn Session. We will be covering the following items: Breast Cancer [...]Read more
UPDATE – Changes to Proposition 56: Family Planning Services (All Plan Letter 22-011)
October 3, 2022 / by Health Plan / Alerts
Date: October 3, 2022 To: HPSJ Contracted Providers From: Health Plan of San Joaquin (HPSJ) Subject: UPDATE – Changes to Proposition 56: Family Planning Services (All Plan Letter 22-011) Business: Medi-Cal The following summarizes the Department of Health Care Services (DHCS) All Plan Letter 22-011, which outlines changes to the Proposition 56: Family Planning Services [...]Read more
Reminder – Quest Diagnostic Laboratory Services
October 3, 2022 / by Health Plan / Alerts
Date: October 3, 2022 To: HPSJ Primary Care Providers, Specialists, and Ancillary Providers From: Health Plan of San Joaquin Provider Services Subject: Reminder - Quest Diagnostic Laboratory Services Business: Medi-Cal REMINDER As a Medi-Cal Managed Care Plan, Health Plan of San Joaquin (HPSJ) would like to remind our network providers to utilize Quest Diagnostics for [...]Read more
Provider Appointment Availability Survey Is Here
September 26, 2022 / by Health Plan / Alerts
Date: September 23, 2022 To: Health Plan of San Joaquin Providers From: Health Plan of San Joaquin Provider Services Subject: Provider Appointment Availability Survey Is Here Business: Medi-Cal Health Plan of San Joaquin (HPSJ) is required by the California Department of Managed Health Care (DMHC) to perform an annual Provider Appointment Availability Survey (PAAS). The [...]Read more
Advance Notice of Possible Site Reviews – 2022 DHCS Audit
September 8, 2022 / by Health Plan / Alerts
Date: September 8, 2022 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers and Specialists From: HPSJ Compliance Department Subject: Advance Notice of Possible Site Reviews – 2022 DHCS Audit Business: Medi-Cal The California Department of Health Care Services (DHCS) has scheduled a routine annual medical audit of Health Plan of San Joaquin [...]Read more
Medi-Cal Rx Phase I, Wave III Go-Live
September 7, 2022 / by Health Plan / Alerts
Date: September 7, 2022 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Medi-Cal Rx Phase I, Wave III Go-Live Business: Medi-Cal Managed Care Effective September 16, 2022, 11 Standard Therapeutic Classes (STC) will be reinstated with prior authorization (PA) requirements. The STC [...]Read more