March 22, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Prenatal and Postpartum Provider Incentives Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) HPSJ is pleased to announce 2016 Provider incentives for prenatal and postpartum care. This provider incentive is valid from January 1, 2016 through December 31, 2016. The $25 incentive is […]
Read more
Health Plan of San Joaquin provider Alerts
Update – Refining Continues for System Identification for fraud, waste and abuse capture, as well as claims editing
June 22, 2016 / by Health Plan / Alerts
Date: June 22, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Update – Refining Continues for System Identification for fraud, waste and abuse capture, as well as claims editing Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) There is nothing providers need to do, beyond what your practice […]
Read more
J code Medications – Carved-Out to Fee-for-Service (FFS) Medi-Cal
May 16, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers and Hospitals From: Provider Services Department Subject: J code Medications – Carved-Out to Fee-for-Service (FFS) Medi-Cal Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective July 14, 2016. Certain J code medications are carved-out and should be billed directly to FFS Medi-Cal. In order to determine […]
Read more
Provider Network Demographics and Data Validation Project (Practice)
May 12, 2016 / by Health Plan / Alerts
Date: May 12, 2016 To: Health Plan of San Joaquin (HPSJ) Provider Facilities From: Provider Services Department Subject: Provider Network Demographics and Data Validation Project Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) As you may know, California lawmakers have passed legislation to improve the experience of healthcare consumers. As of July 1, 2016, […]
Read more
Provider Network Demographics and Data Validation Project (Facilities)
May 12, 2016 / by Health Plan / Alerts
Date: May,12 2016 To: Health Plan of San Joaquin (HPSJ) Provider Facilities From: Provider Services Department Subject: Provider Alert – Provider Network Demographics and Data Validation Project (Facilities) Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) As you may know, California lawmakers have passed legislation to improve the experience of healthcare consumers. As of […]
Read more
ADVICE – Correcting CMS-1500 Claims Submissions Also, when NOT to submit a dispute
April 22, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) PCPs, Providers and Practice Billing Managers From: Provider Services Department Subject: ADVICE – Correcting CMS-1500 Claims Submissions Also, when NOT to submit a dispute Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) This advice is offered to help providers with the proper ways to resubmit claims – […]
Read more
Provider Network Demographics and Data Validation Project
April 13, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Provider Network Demographics and Data Validation Project Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) As you may know, California lawmakers have passed legislation to improve the experience of healthcare consumers. As of July 1, 2016, new regulatory standards will be […]
Read more
ADVICE – Proper use of billing modifiers 25 and 59
April 11, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) PCPs, Providers and Practice Billing Managers From: Provider Services Department Subject: ADVICE – Proper use of billing modifiers 25 and 59 Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) To advise providers on the proper use of modifiers 25 and 59 – and to decrease the amount […]
Read more
Provider Alert Formulary Update – 5/20/2016
April 11, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Provider Alert Formulary Update – 5/20/2016 Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective 5/20/2016, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Oral Contraceptives (no […]
Read more
Prenatal and Postpartum Provider Incentives
March 22, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Prenatal and Postpartum Provider Incentives Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) HPSJ is pleased to announce 2016 Provider incentives for prenatal and postpartum care. This provider incentive is valid from January 1, 2016 through December 31, 2016. The $25 incentive is […]
Read more
Changes to Prior Authorization Requirements – CT Scans, Ultrasounds and Mammograms
March 8, 2016 / by Health Plan / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Changes to Prior Authorization Requirements – CT Scans, Ultrasounds and Mammograms Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective June 15, 2016. Our providers are important partners in delivering care to our patients. As we seek more ways to streamline […]
Read more