Health Plan of San Joaquin provider Alerts

Claim Overpayments

Date: May 16, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners and Providers From: HPSJ Claims Department Subject: Claim Overpayments Business: Medi-Cal Managed Care Coming Soon: Electronic PCP Selection Change Form California’s Department of Health Care Services (DHCS) has issued an All Plan Letter, APL 17-003. Here is what you, as a provider, need […]

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UPDATE: Proposition 56 Supplemental Payment for Physician Services

Date: May 3, 2018 To: Health Plan of San Joaquin (HPSJ) PCPs and Specialists From: HPSJ Claims Department Subject: UPDATE: Proposition 56 Supplemental Payment for Physician Services Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) received the Centers for Medicare & Medicaid Services (CMS) approval of the State Plan Amendment (SPA) 17-030. […]

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Provider Alert – Pulse Oximetry – 94760

Date: April 4, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners and Providers From: HPSJ Claims Department Subject: Pulse Oximetry – 94760 Business: Medi-Cal We have identified a system error which unfortunately has been inappropriately paying physicians for CPT 94760. The error has now been fixed. A recovery request will be sent out to […]

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PCP Selection Change Form Automation

Date: April 4, 2018 To: Health Plan of San Joaquin (HPSJ) Primary Care Practitioners From: HPSJ Provider Services Department Subject: PCP Selection Change Form Automation Business: Medi-Cal Managed Care Coming Soon: Electronic PCP Selection Change Form Our HPSJ network providers are important partners in delivering care to our members. As we continue to see ways […]

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Canceled – 3/22 – LUNCH & LEARN EVENT – Palliative Care Implementation, effective January 1, 2018

Date: March 20, 2018 To: ALL: Primary Care Physicians, Oncologists, Cardiologists, Gastroenterologists, Pulmonologists From: Medical Management Department – Case Management Subject: Canceled – 3/22 – LUNCH & LEARN EVENT – Palliative Care Implementation, effective January 1, 2018 Business: Medi-Cal   LUNCH & LEARN EVENT HAS BEEN CANCELED Health Plan of San Joaquin Lunch & Learn […]

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Mandatory Reporting of Immunization Information

Date: March 13, 2018 To: Primary Care Providers and Pharmacies From: Health Plan of San Joaquin Pharmacy Department Subject: Mandatory Reporting of Immunization Information Business: Medi-Cal The Department of Health Care Services (DHCS) strongly recommends that all Managed Care Plan (MCP) network providers report immunization information within 14 days of administering an immunization. The following […]

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Mandatory Reporting of Immunization Information

Date: March 13, 2018 To: Primary Care Providers and Pharmacies From: Health Plan of San Joaquin Pharmacy Department Subject: Mandatory Reporting of Immunization Information Business: Medi-Cal The Department of Health Care Services (DHCS) strongly recommends that all Managed Care Plan (MCP) network providers report immunization information within 14 days of administering an immunization. The following […]

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Formulary Update – The Pharmacy and Therapeutics Committee has approved the following changes

Date: February 27, 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 – The Pharmacy and Therapeutics Committee has approved the following changes Business: Medi-Cal Effective 05/02/2018, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to […]

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Coordination of Benefits Agreement (COBA)

Date: February 26, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners and Providers From: HPSJ Claims Department Subject: Coordination of Benefits Agreement (COBA) Business: Medi-Cal Great News!! In accordance with the transaction and code sets adopted by the Secretary of Health & Human Services through a final rule published in 45 CFR 162, Health […]

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Effective Immediately – Additional Changes to Prior Authorization Requirements

Date: February 22, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners and Providers From: HPSJ Medical Management Department Subject: Effective Immediately – Additional Changes to Prior Authorization Requirements Business: Medi-Cal Effective immediately As we continue to seek ways to streamline processes, HPSJ has simplified prior authorization requirements for your busy office. A prior authorization […]

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