July 12, 2022 / by Health Plan / Alerts
Date: July 11, 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 July 20, 2022, from 12:00 pm to 1:00 pm, for a Virtual Provider Look and Learn Session. We will be covering the following items: WIC Services [...]
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Health Plan of San Joaquin provider Alerts
Follow-up After Emergency Department Visit for Substance Use (FUA)
July 14, 2022 / by Health Plan / Alerts
Date: July 14, 2022 To: CONTRACTED PCPs and Behavioral Health Care Providers From: Health Plan of San Joaquin (HPSJ) Subject: Follow-up After Emergency Department Visit for Substance Use (FUA) Business: Medi-Cal HEDIS Measure Change 2022 Follow- up After Emergency Department Visit for Substance Use: Revised measure name from Follow-up After Emergency Department for Alcohol and [...]Read more
Follow-up After Emergency Department Visit for Substance Use (FUA)
July 14, 2022 / by Health Plan / Alerts
Date: July 14, 2022 To: CONTRACTED PCPs and Behavioral Health Care Providers From: Health Plan of San Joaquin (HPSJ) Subject: Follow-up After Emergency Department Visit for Substance Use (FUA) Business: Medi-Cal HEDIS Measure Change 2022 Follow- up After Emergency Department Visit for Substance Use: Revised measure name from Follow-up After Emergency Department for Alcohol and [...]Read more
Modifier 22 Documentation Requirements
July 14, 2022 / by Health Plan / Alerts
Date: July 12, 2022 To: HPSJ Providers & Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Modifier 22 Documentation Requirements Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) guidelines state that when billing modifier 22, which indicates that a procedure was complicated, complex, difficult, or took significantly more time than usually [...]Read more
Virtual Look and Learn
July 12, 2022 / by Health Plan / Alerts
Date: July 11, 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 July 20, 2022, from 12:00 pm to 1:00 pm, for a Virtual Provider Look and Learn Session. We will be covering the following items: WIC Services [...]Read more
REMINDER- Authorization Required on Claims
July 6, 2022 / by Health Plan / Alerts
Date: July 5, 2022 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Subject: REMINDER- Authorization Required on Claims Business: Medi-Cal Managed Care An internal claims audit revealed that the prior authorization number (entered on a CMS 1500 claim form) and the treatment authorization number (entered on a UB04 claim form) [...]Read more
Proposition 56 Value-Based Payment Programing Has Ended
July 6, 2022 / by Health Plan / Alerts
Date: July 5, 2022 To: HPSJ Primary Care Providers (PCP) and Contracted Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Proposition 56 Value-Based Payment Programing Has Ended Business: Medi-Cal Managed Care The Value-Based Payment (VBP) Program has ended effective June 30, 2022. The VBP Program was directed to Managed Care Plans (MCPs) to make [...]Read more
Revised DHCS Facility Site Review and Medical Record Review Tools and Standards
July 1, 2022 / by Health Plan / Alerts
Date: July 1, 2022 To: Health Plan of San Joaquin (HPSJ) PCP’s and FQHCs From: HPSJ Quality Management Department Type: Informational/Regulatory Subject: Revised DHCS Facility Site Review and Medical Record Review Tools and Standards Business: Medi-Cal Managed Care Beginning July 1, 2022, the Department of Health Care Services (DHCS) will be implementing the use of [...]Read more
2022 Mandatory Annual Trainings Final Reminder
July 1, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers & Facilities From: Health Plan of San Joaquin Subject: 2022 Mandatory Annual Trainings Final Reminder Business: Medi-Cal ACTION REQUIRED Please complete ALL THREE trainings by June 30, 2022 Annual training is mandated by California’s Department of Health Care Services (DHCS) and the [...]Read more
Medical Benefit Updates
June 30, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective September 5, 2022, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit: Code J2357 - INJECTION, OMALIZUMAB [...]Read more
Reminder: Phase 2: ECM and Community Supports – San Joaquin and Stanislaus Counties
June 30, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: HPSJ Primary Care Providers, Specialists, Hospitals and Facilities From: Health Plan of San Joaquin Subject: Reminder: Phase 2: ECM and Community Supports – San Joaquin and Stanislaus Counties Business: Medi-Cal Enhanced Care Management and Community Supports Starting in January of 2022, new benefits and services called Enhanced Care Management (ECM) [...]Read more