February 22, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Date: February 22, 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 Business: Medi-Cal Effective 04/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Sodium Ferric Gluconate/Sucrose (Ferrlecit) 62.5mg/5ml vial: No restrictions. Ferumoxytol [...]
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Health Plan of San Joaquin provider Alerts
Enhanced Provider Dispute Resolution (PDR) Process
April 14, 2021 / by Health Plan / Alerts
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, [...]Read more
Clinical Review: Recommendations for the Tapering of Benzodiazepines
April 2, 2021 / by Health Plan / Alerts, Pharmacy Announcements
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
March 23, 2021 / by Health Plan / Alerts
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 [...]Read more
20 Myth Busters: COVID-19 Vaccinations
March 23, 2021 / by Health Plan / Alerts
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. [...]Read more
COMING SOON: Enhanced Provider Dispute Resolution (PDR) Process
March 10, 2021 / by Health Plan / Alerts
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 [...]Read more
Claims Corner Spotlights – March 2021
March 9, 2021 / by Health Plan / Alerts, Claims Corner
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. [...]Read more
Proprietary Laboratory Analyses (PLA) Codes
March 1, 2021 / by Health Plan / Alerts
Date: February 26, 2021 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: Proprietary Laboratory Analyses (PLA) Codes Business: Medi-Cal Managed Care In an ongoing effort to keep our Providers informed of upcoming changes, HPSJ would like to take this opportunity to provide an update regarding PLA codes. [...]Read more
Information found on the HPSJ Website
February 25, 2021 / by Health Plan / Alerts
Date: February 25, 2021 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP), OBGYN and All Specialist From: Health Plan of San Joaquin Subject: Information found on the Website Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) would like to remind you about our website http://www.hpsj.com. We include information about many [...]Read more
Leading Screening – Children
February 24, 2021 / by Health Plan / Alerts
Date: February 25, 2021 To: Health Plan of San Joaquin (HPSJ Providers From: Health Plan of San Joaquin Subject: Leading Screening - Children Business: Medi-Cal Childhood Blood Screenings Noted: Gaps for your HPSJ patients Federal & Quality Measure Requirements In 2021, HPSJ will send quarterly communications to your office highlighting the list of members who [...]Read more
Formulary updates effective for April 19, 2021
February 22, 2021 / by Health Plan / Alerts, Pharmacy Announcements
Date: February 22, 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 Business: Medi-Cal Effective 04/19/2021, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Sodium Ferric Gluconate/Sucrose (Ferrlecit) 62.5mg/5ml vial: No restrictions. Ferumoxytol [...]Read more