Skilled Nurse Facilities (SNF) / Long Term Care (LTC) Erroneous Denials
| Date: | October 04, 2023 |
| To: | Health Plan of San Joaquin (HPSJ) All Providers and Facilities |
| Type: | Regulatory/Informational |
| Subject: | Skilled Nurse Facilities (SNF)/ Long Term Care (LTC) Erroneous Denials |
| Business: | Medi-Cal Managed Care |
HPSJ has identified an issue where denial notices were incorrectly issued for “admission date is greater than the statement through date” for all Skilled Nursing and Long-Term Care Facilities.
We have taken immediate action to rectify this problem by updating our systems, and as a result, all affected claims are currently undergoing reprocessing. Providers are not required to take any additional steps in this regard.
We kindly request that Corrected Claims or Provider Disputes not be submitted, as we will automatically adjust all claims that were erroneously denied.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/.