December 24, 2014 / by Health Plan / Alerts
December 24, 2014 Provider Alert To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Provider Relations Department Subject: Holiday Service Hours Products: All Health Plan of San Joaquin and San Joaquin Health Administrators will be closed as follows: Wednesday, December 24, 2014 Closed 3:00pm – 5:00pm Thursday, December 25, 2014 Closed Thursday, January […]
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Health Plan of San Joaquin provider Alerts
HPSJ 2014 Holiday Service Hours
December 24, 2014 / by Health Plan / Alerts
December 24, 2014 Provider Alert To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Provider Relations Department Subject: Holiday Service Hours Products: All Health Plan of San Joaquin and San Joaquin Health Administrators will be closed as follows: Wednesday, December 24, 2014 Closed 3:00pm – 5:00pm Thursday, December 25, 2014 Closed Thursday, January […]
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Introducing the new Health Plan of San Joaquin Website
December 18, 2014 / by Health Plan / Alerts
To: All Providers From: Health Plan of San Joaquin Subject: New HPSJ Website Products: Medi-Cal Managed Care Introducing the new Health Plan of San Joaquin Website Health Plan of San Joaquin is excited to announce the launch of our newly designed website, hpsj.com, set to go live on Monday, December 22, 2014. Our goal was […]
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New Prior Authorization Form
December 4, 2014 / by Health Plan / Alerts
December 1, 2014 PROVIDER ALERT To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy Department Subject: New Prior Authorization Form Required effective 1/1/2015 Products: All Senate Bill (SB) 866 will become effective for DMHC regulated Health Plans (including HPSJ) on January 1st, 2015. This law requires […]
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Recommendations For Synagis 2014-2015
November 21, 2014 / by Health Plan / Alerts
RECOMMENDATIONS FOR SYNAGIS 2014-2015 CPT Code 96372 The American Academy of Pediatrics (AAP) recommends the use of palivizumab (Synagis), an RSV monoclonal antibody vaccine, to prevent serious RSV illness in qualifying high-risk infants. The 2014 AAP recommendations (Red Book 29th edition) as well as the 2014 CCS Synagis Guidelines (NL: 13-0914) are incorporated into the […]
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Annual Access Study
November 21, 2014 / by Health Plan / Alerts
November 21, 2014 PROVIDER ALERT To: Primary Care Providers (PCP) and Specialists From: Quality Management Department Subject: Annual Access Study Products: Medi-Cal The California Department of Managed Health Care requires health plans to establish metrics for measuring and monitoring the adequacy of a health plan’s contracted provider network to provide enrollees with timely access to […]
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ACA Section 1202 Payment – 10/29/2014
November 14, 2014 / by Health Plan / Alerts
October 21, 2014 ACA Section 1202 Payment Provider Alert To: HPSJ Providers (Excluding Federally Qualified Health Clinics (FQHC) and Rural Health Clinics (RHCs) From: Provider Relations Department Pursuant to the Affordable Care Act (ACA) as amended by the H.R. 4872-24 Health Care and Education Reconciliation Act of 2010, Section 1202, ACA and 42 Code of […]
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PCP Assignments for Duals – 10/24/2014
November 14, 2014 / by Health Plan / Alerts
PCP Assignments for HPSJ Members with Dual Coverage To: Health Plan of San Joaquin Providers From: Provider Services Department Product: Medicare/Medi-Cal Program Effective October 1, 2014, HPSJ members’ covered by Medicare Part B or Medicare Part A & B will not have an HPSJ primary care provider designated. ID cards issued after October 15th will […]
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Formulary Update HPSJ -10/21/2014
November 14, 2014 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Date: September 16, 2014 Subject: Formulary status changes Products: Medi-Cal, AIM Formulary Update Effective 9/16/2014, the Pharmacy and Therapeutics Committee has approved the following changes. Formulary Status Changes: Rabeprazole (Aciphex) – Prior authorization (PA) required. […]
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Formulary Update SJHA – 10/21/2014
November 14, 2014 / by Health Plan / Alerts
To: San Joaquin Health Administrators (SJHA) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Date: September 16, 2014 Subject: Formulary status changes Products: SJHA Formulary Update Effective 9/16/2014, the Pharmacy and Therapeutics Committee has approved the following changes. Formulary Status Changes: Adalimumab (Humira), Etanercept (Enbrel), Golimumab (Simponi) – Additional indication […]
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Dental Anesthesia Services – Medi-Cal Program – 10/2/2014
September 26, 2014 / by Health Plan / Alerts
September 26, 2014 Dental Anesthesia Services – Medi-Cal Program To: Health Plan of San Joaquin Dental Anesthesia Providers From: Provider Services Department Recently, Health Plan of San Joaquin discovered some irregularities in our Medi-Cal dental authorization requests for general anesthesia. We want to take this opportunity to remind you of the requirements for general anesthesia […]
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