Health Plan of San Joaquin provider Alerts

REMINDER and SUPPORT FROM HPSJ – Prior Authorization (PA) | National Drug Codes (NDC) | Other Health Coverage (OHC)

Date: April 20, 2021 To: Health Plan of San Joaquin (HPSJ) Oncology Providers From: Health Plan of San Joaquin  Subject: REMINDER and SUPPORT FROM HPSJ - Prior Authorization (PA) | National Drug Codes (NDC) | Other Health Coverage (OHC) Business: Medi-Cal Managed Care To support you in becoming familiar with regulatory requirements and help your [...]

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Formulary Update – FORA V30 Meters are replaced with FORA Premium V10 Meters

Date: April 19, 2021 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Subject: Formulary Update – FORA V30 Meters are replaced with FORA Premium V10 Meters Business: Medi-Cal The FORA V30a Blood Glucose Monitors are being discontinued by the manufacturer. Therefore, they will be replaced with [...]

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ENHANCED – Provider Portal Self-Serve Comes to Doctor Referral Express (DRE)

Date: April 15, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers, Clinics & Facilities From: Health Plan of San Joaquin Subject: ENHANCED – Provider Portal Self-Serve Comes to Doctor Referral Express (DRE) Business: Medi-Cal Managed Care To improve your Doctor Referral Express (DRE) experience, HPSJ has implemented a new self-serve automated system to [...]

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Enhanced Provider Dispute Resolution (PDR) Process

Date: April 14, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: Enhanced Provider Dispute Resolution (PDR) Process Business: Medi-Cal Managed Care As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each Provider Dispute Resolution (PDR) is appropriately routed for review, [...]

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Clinical Review: Recommendations for the Tapering of Benzodiazepines

Learning Objectives: Explain why long-term use of benzodiazepines should be limited Describe clinical circumstances when tapering of benzodiazepines should be considered Identify clinical and patient-specific factors to consider when designing a benzodiazepine taper Recognize signs of withdrawal and when to slow down a benzodiazepine taper Key Points: Overprescribing benzodiazepines and co-prescribing benzodiazepines with opioids may […]

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DHCS Encounter Requirements – Date Validation

Date: March 23, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: DHCS Encounter Requirements – Date Validation Business: Medi-Cal Managed Care HPSJ has implemented several new claim denials if claims are not submitted with the required information. This is part of Health Plan of [...]

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20 Myth Busters: COVID-19 Vaccinations

Date: March 22, 2021 To: HPSJ Providers From: Health Plan of San Joaquin Subject: 20 Myth Busters: COVID-19 Vaccinations Business: Medi-Cal As the roll-out of COVID-19 vaccinations continues, we know you have questions. And we know you continue to appreciate more vaccination information while you work to support your patients, as well as our community. [...]

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COMING SOON: Enhanced Provider Dispute Resolution (PDR) Process

Date: March 10, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: COMING SOON: Enhanced Provider Dispute Resolution (PDR) Process Business: Medi-Cal Managed Care As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each Provider Dispute Resolution (PDR) is appropriately routed [...]

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Claims Corner Spotlights – March 2021

COVID-19 Resources for Providers – hpsj.com/covid-19-provider-information/ Virtual Briefing on Vaccinations (2/17/21) HPSJ Claims Director Terry Cumpian joined San Joaquin and Stanislaus County Health Officers, and host HPSJ Chief Medical Officer Dr. Lakshmi Dhanvanthari, for this event. SEE the recorded event video. DOWNLOAD the slides from county health officers Dr. Maggie Park and Dr. Julie Vaishampayan. [...]

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