Health Plan of San Joaquin provider Alerts

Quarterly Provider Incentive – Newly Enrolled HPSJ Member Initial Health Assessment (IHA)

Date: August 5, 2016 To: Health Plan of San Joaquin (HPSJ) PCPs and OB/GYNs From: Provider Services Department Subject: Quarterly Provider Incentive – Newly Enrolled HPSJ Member Initial Health Assessment (IHA) Business: Medi-Cal ALL Members should have IHA within first 120 days of HPSJ Enrollment It is important for newly enrolled HPSJ members to receive […]

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Dental Intravenous Sedation and General Anesthesia authorization requirements

Date: July 25, 2016 To: Health Plan of San Joaquin (HPSJ) Providers and Dental Surgery Centers From: HPSJ Provider Services Department Subject: Dental Anesthesia Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective September 24, 2016 In order to provide clarification on the Dental Intravenous Sedation and General Anesthesia authorization requirements, Health Plan of […]

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Restored acupuncture services as a covered benefit under the MediCal program

Date: July 25, 2016 To: To: Health Plan of San Joaquin (HPSJ) Providers From: HPSJ Provider Services Department Subject: Acupuncture Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective July 1, 2016 California Assembly Bill AB 833 restored acupuncture services as a covered benefit under the MediCal program, Medi-Cal Managed Care Plans, and Cal […]

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Changes to Prior Authorization Requirements

Date: July 22, 2016 To: HPSJ Primary Care Physicians, Pediatricians, OBGyn’s From: Provider Services Department Subject: Changes to Prior Authorization Requirements Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Our HPSJ network providers are important partners in delivering care to our members. As we continue to seek ways to streamline processes, HPSJ has […]

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Z3A Diagnosis Category Information

Date: July 22, 2016 To: HPSJ Primary Care Physicians, Pediatricians, OBGyn’s From: Provider Services Department Subject: Provider Alert – Z3A Diagnosis Category Information Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) We understand the importance of a healthy pregnancy. Health education information and resources can support and encourage a successful pregnancy. HPSJ would […]

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Access Standards for Appointments

Date: July 15, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Access Standards for Appointments Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Recently, Health Plan of San Joaquin (HPSJ) sponsored a survey on the subject of timely access for appointments. Our results revealed that not all […]

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Formulary Update – Health Plan of San Joaquin (HPSJ) Physicians and Providers

Date: June 14, 2016 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update – Health Plan of San Joaquin (HPSJ) Physicians and Providers Business: Medi-Cal, AIM Effective by 8/16/2016, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the […]

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REMINDER – Billing for Non-Physician Practitioners

Date: June 15, 2016 To: Health Plan of San Joaquin (HPSJ) PCPs, Providers and Practice Billing Managers From: Provider Services Department Subject: REMINDER – Billing for Non-Physician Practitioners Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) To decrease the amount of claim denials to providers and incoming disputes to HPSJ, the following guidance is […]

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Community Health Education and Engagement Referral (CHEER) Program

Date: June 22, 2016 To: HPSJ Primary Care Physicians and Partner Organizations From: Provider Services Department Subject: Community Health Education and Engagement Referral (CHEER) Program Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) An effective health education system is essential to promoting HPSJ member involvement in health care decisions, effective use of healthcare […]

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NEW – DRE Quality Incentive Dashboard

Date: June 22, 2016 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Provider Services Department Subject: NEW – DRE Quality Incentive Dashboard Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) is pleased to announce the launch of the new Quality Incentive Dashboard, located in […]

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