Newly Enrolled HPSJ Members – Requirement Initial Health Assessment (IHA) & Staying Health Assessment (SHA)
|Date:||July 30, 2021|
|To:||Health Plan of San Joaquin (HPSJ) CONTRACTED PCPs|
|From:||Health Plan of San Joaquin|
|Subject:||Newly Enrolled HPSJ Members – Requirement
Initial Health Assessment (IHA) & Staying Health Assessment (SHA)
The Staying Healthy Assessment (SHA) is the Department of Health Care Services (DHCS) Individual Health Education Behavior Assessment (IHEBA). Plan providers are required to use and administer the SHA to all Medi-Cal beneficiaries as part of their Initial Health Assessment (IHA) and periodically re-administer it according to contract requirements.
- All newly enrolled members must have a completed IHA (Initial Health Assessment) within the first 120 days of enrollment.
- Members who have changed their PCP within the first 120 days of enrollment, now need a new IHA to be completed.
MORE IHA VALUE for Members and Providers –
An Initial Health Assessment helps ensure members are comprehensively assessed for acute, chronic and preventive healthcare needs. The IHA supports development of the new provider/patient relationship. Physicians and providers may also identify members whose health needs require coordination with community resources from other agencies.
HPSJ offers a $50 incentive to our PCPs for each member who received an IHA within 120 days of HPSJ enrollment. This provider incentive is based on claims/encounters received from both fees for service or capitated providers.
How do you qualify?
- Minimum of 500 members must be paneled per qualifying PCP.
- Panel must remain open the entire incentive year to qualify.
For more information about the SHA and IHA to support your practice:
- To obtain age- and language-specific SHA questionnaires visit the DHCS website at: https://www.dhcs.ca.gov/formsandpubs/forms/Pages/StayingHealthyAssessmentQuestionnaires.aspx
- Find more information for the SHA here:
- Please go to HPSJ’s DRE provider portal to see the Provider Tip Sheet for billing tips for IHA
- For your newly enrolled or assigned members, please see your Monthly Eligibility Lists in HPSJ’s DRE provider portal
Thank you for all you do to provide HPSJ patients outstanding health care! If you have questions, please contact Provider Services at 1.888.936.PLAN (7526).