June 22, 2016 / by Health Plan / Alerts
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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Health Plan of San Joaquin provider Alerts
Community Health Education and Engagement Referral (CHEER) Program
June 22, 2016 / by Health Plan / Alerts
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
June 22, 2016 / by Health Plan / Alerts
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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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 […]
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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 […]
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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, […]
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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 […]
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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 – […]
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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 […]
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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 […]
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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 […]
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