May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Long-Term-Care Facilities From: HPSJ Type: Regulatory/Informational Subject: Supplemental Payment Business: Medi-Cal Managed Care For 2023, Health Plan of San Joaquin (HPSJ) will continue paying a supplemental payment for the first 45 days of admission. Starting July 5, 2023, to receive this supplemental payment, facilities [...]
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Health Plan of San Joaquin provider Alerts
Update – Value Based Payment (VBP) Program
June 28, 2023 / by HPSJ / Alerts
Date: June 28, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Providers From: HPSJ Type: Regulatory/Informational Subject: Update – Value Based Payment (VBP) Program Business: Medi-Cal Managed Care The following is to inform HPSJ Contracted Providers that there will be a delay for the June 2023 Value Based Payment (VBP) program payments. Our HPSJ [...]Read more
Lead Screening in Children (LSC)- 2023 HEDIS Measure
June 28, 2023 / by HPSJ / Alerts
Date: June 28, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Pediatrics and Primary Care Providers (PCP) From: HPSJ Type: Informational Subject: Lead Screening in Children (LSC)- 2023 HEDIS Measure Business: Medi-Cal Managed Care Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2023 Lead Screening in Children (LSC) Guidelines Update All California providers [...]Read more
Eye Injections Reference Sheet for Ophthalmologists
June 28, 2023 / by HPSJ / Alerts
Date: June 28, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners and Facilities From: HPSJ Type: Educational/Informational Subject: Eye Injections Reference Sheet for Ophthalmologists Business: Medi-Cal Managed Care The Pharmacy and Therapeutics (P&T) Committee provided medical benefit updates in a provider alert issued in April of 2023. As a result, the attached informational reference [...]Read more
Dyadic Services and Family Therapy Benefit
June 13, 2023 / by HPSJ / Alerts
Date: June 13, 2023 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers, Specialists, Hospitals and Facilities From: HPSJ Type: State Regulatory Subject: Dyadic Services and Family Therapy Benefit Business: Medi-Cal Managed Care In accordance with All Plan Letter (APL) 22-029, the Dyadic services and family therapy benefit are effective January 1, 2023. Per [...]Read more
Dual Members: Overpayments
May 30, 2023 / by HPSJ / Alerts
Date: May 30, 2023 To: Health Plan of San Joaquin (HPSJ) Long Term Care Providers From: HPSJ Type: Announcement Subject: Dual Members: Overpayments Business: Medi-Cal Managed Care Medicare/Medi-Cal (Dual) HPSJ Members & Long-Term Care Claims for Medicare/Medi-Cal recipients must first be billed to the appropriate Medicare carrier or intermediary for processing of Medicare benefits. Medi-Cal [...]Read more
Long Term Care – Share of Cost (SOC) Value Codes
May 22, 2023 / by HPSJ / Alerts
Date: May 22, 2023 To: Health Plan of San Joaquin (HPSJ) Providers and Facilities From: HPSJ Type: Regulatory/Informational Subject: Long Term Care – Share of Cost (SOC) Value Codes Business: Medi-Cal Managed Care In accordance with guidelines from the Department of Health Care Services (DHCS), providers may collect Share of Cost (SOC) payments from a [...]Read more
Vendor Update
May 22, 2023 / by HPSJ / Alerts
Date: May 22, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners From: HPSJ Type: Informational Subject: Vendor Update Business: Medi-Cal Managed Care Effective May 1, 2023, HPSJ is no longer offering Diabetes Prevention Program through Melon Health. We apologize to our members who may be impacted by this change. HPSJ is working to find [...]Read more
Supplemental Payment
May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Long-Term-Care Facilities From: HPSJ Type: Regulatory/Informational Subject: Supplemental Payment Business: Medi-Cal Managed Care For 2023, Health Plan of San Joaquin (HPSJ) will continue paying a supplemental payment for the first 45 days of admission. Starting July 5, 2023, to receive this supplemental payment, facilities [...]Read more
Skilled Nursing Facility/Long Term Care Payment Issue
May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Skilled Nursing Facility/Long Term Care From: HPSJ Type: Regulatory/Informational Subject: Skilled Nursing Facility/Long Term Care Payment Issue Business: Medi-Cal Managed Care We regret to inform you that due to a technical issue that occurred on March 31, 2023, some long-term care claims may [...]Read more
UPDATE- Monthly Capitation (CAP) Payment Scheduled for May 2023
May 4, 2023 / by HPSJ / Alerts
Date: May 4, 2023 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP) From: HPSJ Type: Informational/Educational Subject: UPDATE- Monthly Capitation (CAP) Payment Scheduled for May 2023 Business: Medi-Cal Managed Care This notice is to inform you that your May 2023 capitation payment will be delayed. We want you to be aware of [...]Read more