August 27, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: New systems coming for fraud, waste and abuse capture, as well as claims editing Products: Medi-Cal, AIM As part of ongoing oversight efforts, state and federal regulators have mandated that health plans, including HPSJ, adapt new state-of-the-art systems regarding both fraud, waste […]
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Health Plan of San Joaquin provider Alerts
Document Requirements for Oxygen/Respiratory Equipment
October 28, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin Providers From: Provider Services Department Subject: Document Requirements for Oxygen/Respiratory Equipment Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective December 15, 2015 We at HPSJ, in collaboration with our network providers, want to ensure that your patients who require home oxygen – either as a new request […]
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Provider Alert – Fluoride Varnish Treatment
October 21, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Primary Care and Specialty Physicians From: Provider Services Department Subject: Increased Reimbursement on Fluoride Varnish Treatment and Expanded Pharmacy Benefit for Fluoride Drops and Tablets Products: Medi-Cal Effective: November 1, 2015 ONLY HPSJ’s Medi-Cal members are affected by the following changes. Fluoride Varnish Treatment Both Primary […]
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Provider Alert Formulary Update
October 21, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin Pharmacy and Therapeutics Committee From: Provider Services Department – Health Plan of San Joaquin Subject: Provider Alert Formulary Update Products: Medi-Cal, AIM Effective 9/23/2015, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Fluticasone Furoate (Arnuity Ellipta) – No PA required. Reserved for patients […]
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HEDIS Member Outreach
October 6, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department – Health Plan of San Joaquin Subject: HEDIS Member Outreach Products: Medi-Cal Managed Care Please help your patients who are HPSJ members when they contact you for an appointment to be seen before December 31. It’s HEDIS time for our HPSJ provider network […]
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Vantage Transport Services Deactivated by DHCS – Effective October 1, 2015
October 2, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Vantage Transport Services Deactivated by DHCS – Effective October 1, 2015 Products: Medi-Cal, AIM HPSJ has been informed by the Department of Health Care Services (DHCS) that it has “deactivated” Vantage Transport as a contracted, Medi-Cal transportation provider. As of October 1, […]
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ICD 10 Monthly Alert September 2015
September 18, 2015 / by Health Plan / Alerts
Health Plan of San Joaquin (HPSJ) is here to help, however your practice must take steps to be ready for the change from ICD-9 to ICD-10 on October 1, 2015. For any claim submitted with incorrect code A clean claim should be submitted. Do not submit a provider dispute or a corrected claim. Prep Your […]
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New systems coming for fraud, waste and abuse capture, as well as claims editing
August 27, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: New systems coming for fraud, waste and abuse capture, as well as claims editing Products: Medi-Cal, AIM As part of ongoing oversight efforts, state and federal regulators have mandated that health plans, including HPSJ, adapt new state-of-the-art systems regarding both fraud, waste […]
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Alert ICD-10 Monthly alert August 2015
August 27, 2015 / by Health Plan / Alerts
Health Plan of San Joaquin (HPSJ) is here to help, however your practice must take steps to be ready for the change from ICD-9 to ICD-10 on October 1, 2015. Prep Your Billing Service and/or Office Staff Government regulations do not allow HPSJ to correct coding errors or provide specific codes. If you have any […]
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Changes: HIPAA Code Conversion for Local Modifier ZS
August 18, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Changes: HIPAA Code Conversion for Local Modifier ZS Products: Medi-Cal, AIM Effective Date: August 1, 2015 An article that published in the April 2015 Medi-Cal Update announced that the effective date for the discontinuation of local modifier ZS would be July 1, […]
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HPSJ Earns NCQA Award for Quality
August 3, 2015 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) From: Provider Services Department Subject: HPSJ Earns NCQA Award for Quality Products: Medi-Cal/Medicaid The National Committee for Quality Assurance (NCQA) recently awarded HPSJ a Three-Year Health Plan Accreditation for its Medicaid/HMO line of business. The official award recognizes HPSJ as “ACCREDITED for service and clinical quality that meet […]
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