March 20, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: March 20, 2020 To: HPSJ Providers, Practices (PCPs & Specialists), Hospitals and Ancillary Facilities From: HPSJ Claims Department Subject: Telehealth Billing Business: Medi-Cal There is no difference in reimbursement rates for office and telehealth visits. For office billing operations – including billing services – please note the following. HPSJ has always had the ability […]
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DHCS Encounter Requirements – Patient Reason DX
July 16, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: July 16, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: DHCS Encounter Requirements – Patient Reason DX Business: Medi-Cal As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each claim submission will reconcile with each encounter submission to the California’s Department […]
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DHCS Encounter Requirements – Claim submissions
July 16, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: July 16, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: HPSJ Claims Department Subject: DHCS Encounter Requirements – Claim submissions Business: Medi-Cal As part of Health Plan of San Joaquin’s (HPSJ) continued efforts to ensure each claim submission will reconcile with each encounter submission to the California’s Department of […]
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Non-Emergency Medical Transportation Billing Requirements
May 8, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: May 7, 2020 To: Health Plan of San Joaquin (HPSJ) NEMT Providers From: HPSJ Claims Department Subject: Non-Emergency Medical Transportation Billing Requirements Business: Medi-Cal Managed Care In accordance with Medi-Cal and California Department of Health Care Services (DHCS) guidelines, the following information outlines the billing requirements for all Non-Emergency Medical Transportation (NEMT) providers. Name […]
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Claims Corner – A newsletter brought to you by Health Plan of San Joaquin – April 23
April 24, 2020 / by HPSJ / Alerts, Claims Corner, Non-Contracted Provider
In this issue: FAQs for this COVID Moment More Helpful Information Reminders Questions about Coronavirus COVID-19? STAY INFORMED FREQUENTLY ASKED QUESTIONS When conducted over the phone, should providers bill their Evaluation and Management (E/M) Office Visits as previously instructed? YES. See #1 & #2 in MORE HELPFUL INFORMATION below. How should providers bill follow-ups, lab [...]Read more
DHCS Guidance for NEMT and NMT Providers: COVID-19
April 15, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: April 15, 2018 To: HPSJ Providers – • Non-Emergency Medical Transportation (NEMT) Providers • Non-Medical Transportation (NMT) ProvidersHPSJ Providers (HPSJ) Providers, Practices, and Facilities From: HPSJ Provider Services Department Subject: DHCS Guidance for NEMT and NMT Providers: COVID-19 Business: Medi-Cal COVID-19 Guidance for NEMT and NMT Providers The Department of Health Care Services (DHCS) [...]Read more
Telehealth Billing Provider Alert
March 20, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: March 20, 2020 To: HPSJ Providers, Practices (PCPs & Specialists), Hospitals and Ancillary Facilities From: HPSJ Claims Department Subject: Telehealth Billing Business: Medi-Cal There is no difference in reimbursement rates for office and telehealth visits. For office billing operations – including billing services – please note the following. HPSJ has always had the ability […]
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Cost Avoidance and Post-Pay Recoveries – Coming DHCS Intervention
March 2, 2020 / by HPSJ / Alerts, Non-Contracted Provider
Date: March 2, 2020 To: Health Plan of San Joaquin (HPSJ) All Practitioners and Facilities From: HPSJ Claims Department Subject: Cost Avoidance and Post-Pay Recoveries – Coming DHCS Intervention Business: Medi-Cal Managed Care State Law requires Medi-Cal and Managed Care Plans (MCP’s) to be the payer of last resort for services in which there is […]
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