TOP TOPICS Monthly Spotlights Just for HPSJ Providers, July 2021

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To ensure no delays in your payments

Action requiredchange in payments system
If you’ve already acted, please disregard this message.

Coming up, we will transition to a new payment system in the fall. To ensure a smooth transition for your electronic payments, please provide the name and email address of the person authorized to make decisions on claims and payments.

Provide this information at
Questions? See,or call HPSJ Provider Services at 209.942.6320.

Look and Learn, Virtual Event

Managed Care Accountability Set
(MCAS) – What you need to know
Aug 19, 2021, 12:30pm-2pm

With back-to-school preparations, you will come away with latest on:

• Well Child Visits (WCV/WCC)
• Childhood and Adolescent Immunizations (CIS/IMA)
• Follow-Up Care for Children Prescribed ADHD Medication (ADD)
• Pediatric Behavioral Health

Register – Email, subject line: August Look and Learn

HPSJ Earns Reaccreditation as a Health Plan – NCQA (National Committee for Quality Assurance)
Thanks to hard work and collaboration throughout our provider network and HPSJ staff, HPSJ in June successfully completed the process for three-year reaccreditation by NCQA. HPSJ has been accredited since 2015.

Clinical Practice Guidelines (2021), Now Online
Find the PDF at

NEW Provider Checklist: VBP Payments & Prop 56 REIMBURSEMENT GUIDE
This is a reminder that visits for HPSJ patients should include the Checklist services – and your practices may qualify for additional VBP/Prop 56 reimbursement.

Note: Encounters occurring at Federally Qualified Health Centers, Rural Health Clinics, American Indian Health Clinics and Cost Based Reimbursement Clinics will be excluded from VBP payment. Find this two-pager at

For Outpatient Care – Current Medications for Outpatients Treatment of COVID-19
Management of COVID-19 is rapidly evolving. There are only a few medications that have obtained Emergency Use Authorization (EUA) from the FDA to treat this disease in the ambulatory population. To assist providers, as you appropriately advocate for and treat patients, HPSJ’s Pharmacy Department has brought together in this single piece all the current FDAauthorized treatment options for outpatient management for COVID-19. See it – and updates – at

Mental Health Experts – Easily Accessed via HPSJ
As so many have lived with the fear and restrictions of COVID19 – especially teens and others who may still struggle, HPSJ’s Online Provider Directory is your link to vetted, daily updated help for HPSJ members. Find behavioral health professionals and facilities at

Appointment Access Standards for Medical Services
We created this chart (DMHC/DHCS Timely Access Standards for Wait Times, Urgent Care and After-Hours – In-Office Wait Times Set/Monitored by HPSJ) for your office. (See Provider Alert July 13, 2021,

Posted on July 30th, 2021 and last modified on August 2nd, 2021.