Health Plan of San Joaquin provider Alerts

UPDATE: Monthly Capitation (CAP) and Fee For Service (FFS) Payments

Date: July 12, 2021 To: Health Plan of San Joaquin (HPSJ) All Contracted and Non-Contracted Providers From: Health Plan of San Joaquin Subject: UPDATE: Monthly Capitation (CAP) and Fee For Service (FFS) Payments Business: Medi-Cal Managed Care We are very sorry there have been processing delays for the payments addressed below. This is to bring [...]

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For Outpatient Patient Care – Current Medications for Outpatient Treatment of COVID-19

Date: July 12, 2021 To: Health Plan of San Joaquin (HPSJ) All Contracted and Non-Contracted Providers From: Health Plan of San Joaquin Subject: For Outpatient Patient Care – Current Medications for Outpatient Treatment of COVID-19 Business: Medi-Cal Managed Care Management of COVID-19 is rapidly evolving. There are only a few medications that have obtained Emergency [...]

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EASIER TO USE & NEW NAME for Gap in Care Reports – HEDIS Integrated Reports

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 [...]

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NEW – 2021 Clinical Practice Guidelines, Now Online

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 [...]

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NEW – Provider Billing and Resource Guide

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 [...]

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Action Required regarding change in payments system

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 [...]

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Update – Grievance Process

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 [...]

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HEDIS season 2021 Audit Completed

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 [...]

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UPDATE Value Based Payment (VBP) Program

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 [...]

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Claims Look-Up Tool – For Non-Contracted Providers

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 [...]

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