December 15, 2016 / by Health Plan / Alerts
Date: December 15, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: HPSJ Medical Management Department Subject: Pregnancy: Early Care & Diagnostic Services Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) strives to maintain, update and educate on the guidelines set forth by Medi-Cal (MCAL), while […]
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Health Plan of San Joaquin provider Alerts
Effective 2/21/2017, the Pharmacy and Therapeutics Committee has approved the following changes:
December 21, 2016 / by Health Plan / Alerts
Date: December 21, 2016 To: Health Plan of San Joaquin (HPSJ) Providers and Practitioners From: HPSJ Medical Management Department Subject: Comprehensive Tobacco Cessation Services Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Additions to the Formulary: Potassium Citrate ER 15 mEq (Urocit-K): No PA required. Alemtuzumab (Lemtrada): PA required. Restricted to neurologists. Documented diagnosis […]
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REMINDER: Coordination of care Between Emergency Departments and Primary Care Physicians (PCPs)
December 19, 2016 / by Health Plan / Alerts
Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Emergency Department Providers From: HPSJ Medical Management Department Subject: REMINDER: Coordination of care Between Emergency Departments and Primary Care Physicians (PCPs) Business: Medi-Cal Emergency Department Partners: This is a reminder to our contracted acute care hospital Emergency Departments of the importance of the coordination of […]
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REMINDER: Coordination of Care Between Hospitals and Primary Care Physicians (PCPs)
December 19, 2016 / by Health Plan / Alerts
Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Hospital Providers From: HPSJ Medical Management Department Subject: REMINDER: Coordination of Care Between Hospitals and Primary Care Physicians (PCPs) Business: Medi-Cal Hospital Partners: This is a reminder to our contracted acute care hospitals of the importance of the coordination of care between hospitals and the […]
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Medical Necessity Reviews Change & Prior Authorization Requests Reminder
December 19, 2016 / by Health Plan / Alerts
Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Medical Management Departmentt Subject: Medical Necessity Reviews Change & Prior Authorization Requests Reminder Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) strives to maintain, update and educate on the guidelines set forth by Medi-Cal (MCAL), […]
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Affirmative Statement about Utilization Management Incentives – REMINDER
December 19, 2016 / by Health Plan / Alerts
Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Medical Management Department Subject: Affirmative Statement about Utilization Management Incentives – REMINDER Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) The mission of Health Plan of San Joaquin is to continuously improve the health of our community. HPSJ supports its […]
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REMINDER: Coordination of Care Between Skilled Nursing Facilities (SNF) and Primary Care Physicians (PCPs)
December 19, 2016 / by Health Plan / Alerts
Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Providers and Practitioners From: HPSJ Medical Management Department Subject: REMINDER: Coordination of Care Between Skilled Nursing Facilities (SNF) and Primary Care Physicians (PCPs) Business: Medi-Cal Skilled Nursing Facility Partners: This is a reminder to our contracted Skilled Nursing Facilities of the importance of the coordination […]
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California Children Services (CCS) Eligible Services
December 15, 2016 / by Health Plan / Alerts
Date: December 15, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Claims Department Subject: California Children Services (CCS) Eligible Services Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) strives to maintain, update and educate on the guidelines set forth by Medi-Cal (MCAL) while continually seeking ways […]
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Pregnancy: Early Care & Diagnostic Services
December 15, 2016 / by Health Plan / Alerts
Date: December 15, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: HPSJ Medical Management Department Subject: Pregnancy: Early Care & Diagnostic Services Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) strives to maintain, update and educate on the guidelines set forth by Medi-Cal (MCAL), while […]
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Provider Network Demographics & Data Validation Project (EDI 274)
December 14, 2016 / by Health Plan / Alerts
Date: December 14, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Provider Network Demographics & Data Validation Project (EDI 274) Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) To meet the Department of Health Care Services (DHCS) Deadlines, we must have your information before Dec. 30. Why? […]
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Facility Demographics & Data Validation Project (EDI 274)
November 30, 2016 / by Health Plan / Alerts
Date: November 30, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Facility Demographics & Data Validation Project (EDI 274) Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) To meet the Department of Health Care Services (DHCS) deadlines, we must have your information before Dec. 30. Why? Since […]
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