May 13, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Date: May 13, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update - Effective 07/19/2021 Business: Medi-Cal Effective 07/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Teprotumumab (Tepezza) 500mg vial: Reserved for [...]
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Health Plan of San Joaquin provider Alerts
EASIER TO USE & NEW NAME for Gap in Care Reports – HEDIS Integrated Reports
July 9, 2021 / by Health Plan / Alerts
Date: July 9, 2021 To: Health Plan of San Joaquin (HPSJ) Contracted Providers From: Health Plan of San Joaquin Subject: EASIER TO USE & NEW NAME for Gap in Care Reports – HEDIS Integrated Reports Business: Medi-Cal Managed Care The HEDIS Integrated Reports (formerly called Gap in Care Reporting) are available! Thanks to feedback from [...]Read more
NEW – 2021 Clinical Practice Guidelines, Now Online
June 24, 2021 / by Health Plan / Alerts
Date: June 24, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: NEW - 2021 Clinical Practice Guidelines, Now Online Business: Medi-Cal Managed Care The 2021 Clinical Practice Guidelines are nationally recognized and based on latest clinical evidence. They were reviewed by HPSJ’s Medical Director [...]Read more
NEW – Provider Billing and Resource Guide
June 17, 2021 / by Health Plan / Alerts
Date: June 16, 2021 To: Health Plan of San Joaquin (HPSJ) All Contracted Providers & Facilities From: Health Plan of San Joaquin Subject: NEW - Provider Billing and Resource Guide Business: Medi-Cal Managed Care HPSJ is excited to announce our new Provider Billing and Resource Guide! The Provider Billing and Resource Guide provides information to [...]Read more
Action Required regarding change in payments system
June 7, 2021 / by Health Plan / Alerts
Date: June 7, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Subject: Action Required regarding change in payments system Business: MEDI-CAL HPSJ will soon be transitioning to a new payment solution. This change brings many advantages, but we need your help to ensure a smooth [...]Read more
Update – Grievance Process
June 7, 2021 / by Health Plan / Alerts
Date: June 4, 2021 To: Health Plan of San Joaquin Contracted Practitioners, Providers & Facilities From: Health Plan of San Joaquin Subject: Update – Grievance Process Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) require Health Plan of San Joaquin (HPSJ) to monitor and [...]Read more
HEDIS season 2021 Audit Completed
May 25, 2021 / by Health Plan / Alerts
Date: May 25, 2021 To: Health Plan of San Joaquin (HPSJ) CONTRACTED PROVIDERS From: Health Plan of San Joaquin Subject: HEDIS season 2021 Audit Completed Business: Medi-Cal The HEDIS team in the Quality Department of Health Plan of San Joaquin (HPSJ) would like to thank you for your efforts and delivery of medical records during [...]Read more
UPDATE Value Based Payment (VBP) Program
May 18, 2021 / by Health Plan / Alerts
Date: May 18, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: ~UPDATE~ Value Based Payment (VBP) Program Business: Medi-Cal Managed Care The following is an update for the Value Based Payment (VBP) Program operations. HPSJ is in the process of implementing a technical update to our [...]Read more
Claims Look-Up Tool – For Non-Contracted Providers
May 18, 2021 / by Health Plan / Alerts
Date: May 18, 2021 To: Health Plan of San Joaquin (HPSJ) Contracted and Non-Contracted Providers From: Health Plan of San Joaquin Subject: Claims Look-Up Tool – For Non-Contracted Providers Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) has a helpful tool, outside of the provider portal, for contracted and non-contracted providers to track [...]Read more
Drug Safety Communication: Potential Increased Arrhythmia Risk from Lamotrigine
May 13, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Lamotrigine is a sodium channel blocker that is used alone or in combination with other medicines to treat seizures. Lamotrigine may also be used as a maintenance treatment for bipolar disorder to help delay the occurrence of mood episodes such as depression, mania, or hypomania. On March 31, 2021, the U.S. Food and Drug Administration [...]Read more
Formulary Update – Effective 07/19/2021
May 13, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Date: May 13, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update - Effective 07/19/2021 Business: Medi-Cal Effective 07/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes. Additions to the Formulary Teprotumumab (Tepezza) 500mg vial: Reserved for [...]Read more