May 17, 2018 / by Health Plan / Alerts
Date: May 17, 2018 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 July 23, 2018 Business: Medi-Cal Effective 07/23/2018, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Alirocumab (Praluent): PA required. Reserved […]
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Health Plan of San Joaquin provider Alerts
FREE Webinar: Neonatal abstinence syndrome (NAS)
July 18, 2018 / by Health Plan / Alerts
Date: July 18, 2018 To: Health Plan of San Joaquin (HPSJ) Providers and Practices From: HPSJ Medical Management Department Subject: FREE Webinar: Neonatal abstinence syndrome (NAS) Business: Medi-Cal As Health Plan of San Joaquin continues to work on the opioids crisis in collaboration with community partners throughout our San Joaquin and Stanislaus county service area, […]
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System Correction: Revenue Codes for Inpatient Claims
July 11, 2018 / by Health Plan / Alerts
Date: July 11, 2018 To: Health Plan of San Joaquin (HPSJ) Facilities From: HPSJ Claims Department Subject: System Correction: Revenue Codes for Inpatient Claims Business: Medi-Cal HPSJ has identified a system issue in which non-covered Revenue Codes are incorrectly paying. In accordance with the Medi-Cal guidelines, claims received with an invalid Revenue Code will deny. […]
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THANK YOU! Provider Satisfaction Survey
July 7, 2018 / by Health Plan / Alerts
Date: July 2, 2018 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: THANK YOU! Provider Satisfaction Survey Business: Medi-Cal HPSJ has now completed our annual provider satisfaction survey. Thank you for your participation. Your candid feedback is appreciated. Your input and suggestions allow us to better serve you as well […]
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Important Information: Grievances and Grievance Replies
July 6, 2018 / by Health Plan / Alerts
Date: July 6, 2018 To: All Health Plan of San Joaquin (HPSJ) Contracted Providers, Facilities, and Ancillary Services From: HPSJ Quality Management Department Subject: Important Information: Grievances and Grievance Replies Business: Medi-Cal Health Plan of San Joaquin (HPSJ) is charged with maintaining the quality of care for our members and as such must investigate or […]
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Provider Onsite visit by DHCS
July 2, 2018 / by Health Plan / Alerts
Date: July 2, 2018 To: Health Plan of San Joaquin (HPSJ) PCPs From: HPSJ Medical Management /Quality Subject: Provider Onsite visit by DHCS Business: HPSJ Medi-Cal Provider Visits DHCS Nurse Evaluator may schedule an onsite visit Please be advised that HPSJ will be undergoing a Department of Health Care Services (DHCS) audit from August 13, […]
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Capitated June Checks – Impacting June Check-Write Only
June 1, 2018 / by Health Plan / Alerts
Date: June 1, 2018 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCPs) From: HPSJ Finance Department Subject: Capitated June Checks – Impacting June Check-Write Only Hard Copy Paper ONLY for the Check and for the Remittance Advice Business: Medi-Cal Managed Care Effective: For the June 2018 Capitation payment only This is to inform […]
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Fee-For-Service Checks – Impacting This Check-Write Only Hard Copy Paper ONLY for the Check and for the Remittance Advice
May 31, 2018 / by Health Plan / Alerts
Date: May 31, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: HPSJ Finance Department Subject: Fee-For-Service Checks – Impacting This Check-Write Only Hard Copy Paper ONLY for the Check and for the Remittance Advice Business: Medi-Cal Managed Care Effective: For this check-write period only This is to inform our practitioners, […]
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REMINDER: HPSJ members cannot be charged for medications
May 29, 2018 / by Health Plan / Alerts, Pharmacy Announcements
Date: May 29, 2018 To: HPSJ Network Pharmacies From: HPSJ Pharmacy Department Subject: REMINDER: HPSJ members cannot be charged for medications Business: Medi-Cal This is a reminder that both the Knox Keene Health Care Service Plan Act of 1975 (H&S §1379, §1385) and California Code of Regulations (28 CCR §1300.67.8) mandate that all providers who […]
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Claims Corner May 2018
May 24, 2018 / by Health Plan / Alerts
A monthly newsletter brought to you by Health Plan of San Joaquin Subscribe to MCSS Today! Providers are encouraged to routinely check the Medi-Cal Update provider bulletins and complete the MCSS Subscriber Form to receive email notifications for newly published Medi-Cal Update bulletins, Newsflash articles and/or System Status Alerts. Submitting a Corrected Claim—Reminder Correcting electronic […]
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Formulary Update Effective July 23, 2018
May 17, 2018 / by Health Plan / Alerts
Date: May 17, 2018 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 July 23, 2018 Business: Medi-Cal Effective 07/23/2018, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Alirocumab (Praluent): PA required. Reserved […]
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