Health Plan of San Joaquin provider Alerts

Changes: HIPAA Code Conversion for Local Modifier ZS

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

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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ICD-10 Boot Camps – Happening Soon!

San Joaquin Medical Society, Aug 10-11, at Health Plan of San Joaquin (French Camp) Stanislaus Medical Socielty, Aug 12-13, at the Double Tree by Hilton (Modesto) Register at 1800-786-4262 or at www.cmanet.org/aapc-icd10 Prep Your Billing Service &/or Staff Government regulations do not allow us to correct billing code errors, or provide specific codes. HPSJ staff […]

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Specialist ICD10 Monthly Alert June 3, 2015

Testing Has Started Specialist ICD10 Monthly Alert – We have started the testing process so that you can be confident we will be ready to receive your ICD-10 claims on October 1st. Would You Like to Be a Beta Tester? You can test your own readiness, while helping our entire Provider Network get ready for […]

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Primary Care Provider ICD10 Monthly Alert June 3, 2015

Testing Has Started Primary Care Provider ICD10 Monthly Alert – We have started the testing process so that you can be confident we will be ready to receive your ICD-10 claims on October 1st. Would You Like to Be a Beta Tester? You can test your own readiness, while helping our entire Provider Network get […]

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DMHC and DHCS have scheduled a routine annual joint medical audit of HPSJ

To: Primary Care Providers (PCP) From: Health Plan of San Joaquin Subject: 2015 DMHC/DHCS Joint Audit Products: Medi-Cal Managed Care California’s Department of Managed Health Care (DMHC) and the Department of Health Care Services (DHCS) have scheduled a routine annual joint medical audit of Health Plan of San Joaquin (HPSJ). The medical audit will consist […]

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CHDP PM 160 Changes to the Current Billing Process

To: Primary Care Providers (PCP) From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: CHDP PM 160 Changes to the Current Billing Process Products: Medi-Cal Managed Care Effective: June 30, 2015 As a valued HPSJ provider, we want to make you aware of several coming billing changes. These changes are required by the […]

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Alert Formulary RX Update

To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update Products: Medi-Cal, AIM Effective 4/1/2015, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Zoledronic Acid (Reclast 5mg IV) – PA required. Reserved for patients with documentation […]

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DHCS Reporting Requirements related to Provider-Preventable

To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: DHCS Reporting Requirements related to Provider-Preventable Conditions Business: Medi-Cal As of July 1, 2012 the Federal Affordable Care Act (ACA) requires that providers report all Provider-Preventable Conditions (PPCs) that are associated with claims for Medi-Cal payment or with courses of treatment furnished […]

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Provider Alert – HEDIS Lunch/Learn 4/29/15

Date: Wednesday, April 29, 2015 Time: Noon-1:30 pm Place: Health Plan of San Joaquin/Community Room Audience: Medical Assistants and Office Managers From: Health Plan of San Joaquin How to Improve HEDIS Rates and increase your Provider Incentive Please RSVP to Amanda Y (209) 469-8333 or Crystal (209) 461-2283 no later than Friday, April 24, 2015. […]

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