CHDP PM 160 Changes to Current Billing Process

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February 9, 2015

Provider Alert
To: Primary Care Providers (PCP)
From: Health Plan of San Joaquin
Subject: CHDP PM 160 Changes to Current Billing Process
Products: Medi-Cal Managed Care

As a valued HPSJ provider, we want to make you aware of several billing changes. These changes are required by Department of Health Care Services and have been implemented in accordance with their requirements.

Effective immediately:

  • Brown/White CHDP PM 160 forms must be used when submitting CHDP services.
  • Green/White FFS CHDP PM 160 forms will no longer be accepted by HPSJ.
  • When billing CHDP services, you must also submit a HCFA 1500 billing form or EDI 837 format. Use the correct modifiers when necessary.

Aprl 1, 2015:

  • CHDP PM 160s are no longer accepted through the provider portal, Doctor’s Referral Express (DRE).
  • When billing immunizations, an administration fee must also be billed.
  • CHDP PM 160s will not be accepted at HPSJ’s physical address.
  • Mail CHDP PM 160 forms to:

Health Plan of San Joaquin
P.O. Box 839
El Cerrito, CA 94530

Reminder! For best results locating claims through DRE, our secure provider portal, search using the Member ID or Date of Service.

To create an account and access our secure provider portal, contact Amanda Yang (209) 469-8333, Provider Services Representative.

If you have any questions regarding this alert, please call our Provider Services Department at (209)942-6340.

Posted on February 9th, 2015 and last modified on July 27th, 2015.