Provider Incentive Claims Timeline

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Date: February 21, 2018
To: Health Plan of San Joaquin (HPSJ) Primary Care Providers
From: HPSJ Pharmacy Department
Subject: Provider Incentive Claims Timeline
Business: Medi-Cal

Date for claims to be received by HPSJ
HPSJ is reviewing the data for HEDIS 2017. We will soon send the final claims data for Calendar Year 2017 for processing. Please be sure to submit your claims for 2017 before the end of February so those data can be included in the HEDIS 2017 results.

You have provided the service, so take credit for it!
Your final quarter of incentive for 2017 will include the claims we receive from you through February. This includes your Capitated services as well. This is key in receiving incentive payment for all of the services you’ve performed. Please push the claims submission (Capitated and Fee-for-Service) as early as you can. HPSJ will not be able to include claims received after our data is submitted for the final rates. Every claim is helpful when reviewing all of the HEDIS measures, however, providers will not get incentive credit for claims not received by the HPSJ submission.

If you have questions, please contact your Provider Services Representatives or call our Customer Service Department at 209-942-6320.

Posted on March 9th, 2020