Pricing for Injectables: HPSJ’s Temporary Fix for a DHCS Technical Glitch
| Date: | March 13, 2017 |
| To: | Health Plan of San Joaquin (HPSJ) Providers and Facilities |
| From: | HPSJ Claims Department |
| Subject: | Pricing for Injectables: HPSJ’s Temporary Fix for a DHCS Technical Glitch |
| Business: | Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) |
Health Plan of San Joaquin (HPSJ) strives to keep our network practices and providers upto-date on changes regarding the processing of provider claims.
The Situation: DHCS Glitch
On January 29, 2017 the Department of Health Care Services (DHCS) Medi-Cal website performed an update.
During this update, some managed care plans – including HPSJ – lost access to the MediCal Provider Telecommunication Network (PTN) and the pricing tools associated with that link.
As a result, we have been unable to price injectables submitted with NDC numbers. While the state is aware of this issue and currently is working on a solution, HPSJ has been provided with no date to expect a return to this access for health plans.
A Temporary HPSJ Solution
While DHCS is working to fix this situation, HPSJ has crafted a temporary solution so that we can continue to correctly price your claims for injectables, and do so in a timely way.
Providers are asked to submit their claims with a copy of either of these two items:
- An invoice
- A copy of the printout from the Medi-cal website NDC pricing tool
Fortunately, as a provider you are unaffected by the DHCS update and still able to access the PTN link and its tools.
We understand this is a great inconvenience for our providers. We hope this will be a temporary solution until DHCS can fix the situation.
Please be assured that we will keep you informed of any further changes, or corrections. Meanwhile, thank you very much for your patience and shared efforts during this time, and thank you for continuing to partner with us on behalf of your HPSJ patients.