Health Plan of San Joaquin (HPSJ) is pleased to have you as part of our Provider network. We recognize that the strength of our health care programs depends upon strong collaboration and communication with our Providers and their staff.
The objective of this resource guide is to provide Health Plan of San Joaquin providers with an understanding of our policies and procedures regarding claims and billing for professional and facility services. This resource guide includes detailed information about billing & coding methodologies per Medi-Cal, DHCS, DMHC and CMS reimbursement policies.
In our continuing effort to provide our providers with adequate resources, HPSJ strongly encourages providers to engage in Medi-Cal Provider Training which can be found at https://learn.medi-cal.ca.gov/.
This guide will be revised periodically as needed. Providers will be notified when an updated version becomes effective, and the online version is available on the HPSJ provider website. Additionally, providers may be notified via Provider Alerts and notices posted on the website and potentially on Remittance Advice (RA) notices. Provider Alerts can supersede information within the resource guide.
