TOP TOPICS Monthly Spotlights Just for HPSJ Providers, August 2021

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Childhood Development – Prop 56 information and Survey Invitation

National guidelines recommend developmental screening for all children at 9 months, 18 months, and 30 months of age, and as medically necessary when risk is identified on developmental surveillance.

All children enrolled in Medi-Cal are entitled to receive developmental screenings as this is a required service for children under the Medicaid (Medi-Cal in California) Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit.

Effective: January 1, 2020

  • Target Population: Children up to age 30 months (excludes
    those dually eligible for Medicare and Medi-Cal)
  • Provider types: All
  • CPT Code: 96110 (without modifier KX)
  • Rate: $59.90 (Value Based Payment reimbursement rate)

For more on provider incentive programs, and participation and eligibility, see www.hpsj.com/provider-incentives.

Participate in our survey
HPSJ is inviting you to participate in an assessment of our provider network and the use and efficacy of Childhood Development screening tools. Please participate in the survey at www.hpsj.com/form-view/54.

Required Annual Trainings

Cultural Competency Training
This training is mandated by California’s Department of Health Care Services (DHCS) and the federal Centers for Medicare and Medicaid Services (CMS) to ensure providers and delegated entities are meeting the unique and diverse needs of all members.

Click here, or see page 5 of the latest PlanScan
(Summer 2021, Part 2) at www.hpsj.com/planscan.

Fraud Waste and Abuse Training
Each year, all providers are required to complete this training and then attest that the online materials have been reviewed – or attest FWA training from another organization has been completed.

For more, see the August 20 Provider Alert. You can find online materials and attestation at www.hpsj.com/fraud-waste-andabuse-prevention-training.

Action Required – Avoid Payment Delays
At your first convenience, we need the email address of the person at your practice authorized to make decisions about claims, payments, and bank account.

Provide this information at www.hpsj.com/paycontact.
Questions? See hpsj.com/pay, or call Provider Services at 888.936.7526.

If you are signed up, thank you!

NEW HPSJ Provider Billing and
Resource Guide

NEW HPSJ Provider Billing and Resource Guide

HPSJ’s new resource guide:

  • Includes HPSJ’s policies and procedures
  • Lets you view comprehensive Other Health Coverage (OHC) and Coordination of Benefits (COB) information
  • Gives you timely filing guidance
  • Lists billing requirements and processes to file provider
    disputes.

For more about the new guide, see
www.hpsj.com/provider-billing-andresource-guide

Posted on August 31st, 2021 and last modified on September 1st, 2021.

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