March 9, 2021 / by HPSJ / Alerts, Claims Corner
COVID-19 Resources for Providers – hpsj.com/covid-19-provider-information/ Virtual Briefing on Vaccinations (2/17/21) HPSJ Claims Director Terry Cumpian joined San Joaquin and Stanislaus County Health Officers, and host HPSJ Chief Medical Officer Dr. Lakshmi Dhanvanthari, for this event. SEE the recorded event video. DOWNLOAD the slides from county health officers Dr. Maggie Park and Dr. Julie Vaishampayan. [...]
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Claims Corner Spotlights – March 2021
March 9, 2021 / by HPSJ / Alerts, Claims Corner
COVID-19 Resources for Providers – hpsj.com/covid-19-provider-information/ Virtual Briefing on Vaccinations (2/17/21) HPSJ Claims Director Terry Cumpian joined San Joaquin and Stanislaus County Health Officers, and host HPSJ Chief Medical Officer Dr. Lakshmi Dhanvanthari, for this event. SEE the recorded event video. DOWNLOAD the slides from county health officers Dr. Maggie Park and Dr. Julie Vaishampayan. [...]Read more
DHCS Guidance – COVID-19 Vaccines & Vaccination Administration
January 7, 2021 / by HPSJ / Alerts, Claims Corner, Pharmacy Announcements
Date: January 7, 2021 To: Health Plan of San Joaquin (HPSJ) Providers and Pharmacists From: Health Plan of San Joaquin Subject: DHCS Guidance – COVID-19 Vaccines & Vaccination Administration Business: Medi-Cal The California Department of Health Care Services (DHCS) has now issued guidance for all Medi-Cal managed care health care plans regarding both COVID-19 vaccine [...]Read more
Claims Corner – A newsletter brought to you by Health Plan of San Joaquin – April 23
April 24, 2020 / by HPSJ / Alerts, Claims Corner, Non-Contracted Provider
In this issue: FAQs for this COVID Moment More Helpful Information Reminders Questions about Coronavirus COVID-19? STAY INFORMED FREQUENTLY ASKED QUESTIONS When conducted over the phone, should providers bill their Evaluation and Management (E/M) Office Visits as previously instructed? YES. See #1 & #2 in MORE HELPFUL INFORMATION below. How should providers bill follow-ups, lab [...]Read more
December 2019 – Claims corner newsletter
December 18, 2019 / by HPSJ / Claims Corner
In this issue: Medi/Medi Claim Submissions Newborn Claims/Eligibility Prop 56 Supplemental Payments PDR vs CORR Mailing Address PAPER CLAIMS Effective October 1, 2019 all paper claim submissions should be mailed to the following address: PO BOX 211395 Eagan, MN 55121-2195 Provider Portal—DRE The Provider Portal will allow providers and their administrative staff to have online […]
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September 2019 – Claims corner newsletter
September 30, 2019 / by HPSJ / Claims Corner
NEW Mailing Address (Provider Alert 9.5.2019) Health Plan of San Joaquin (HPSJ) has a new mailing address for initial and corrected paper claim(s) submissions. Effective October 1, 2019 all paper claim submissions should be mailed to: Health Plan of San Joaquin (HPSJ) Paper Processing Facility P.O. Box 211395 Eagan, MN 55121 All claims should be […]
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August 2019 – Claims corner newsletter
August 20, 2019 / by HPSJ / Claims Corner
GO447—New HEDIS Tip Sheet (Provider Alert 7.11.2019) The annual HEDIS Provider Tip Sheet is a tool used to inform providers of the value set codes published at the national level by the measure steward (the National Committee for Quality Assurance). The most recent version of the Provider Tip Sheet is posted on DRE. In the […]
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April 2019 – Claims corner newsletter
May 1, 2019 / by HPSJ / Claims Corner
Offset/Recoupments (Provider Alert 5.16.18) Offsetting Against Future Claims If the provider has not reimbursed HPSJ for the overpayment within sixty (60) days from the date it receives the written notice of HPSJ’s identified overpayment, or denial of written dispute, then HPSJ will provide written notice of the intent to offset. * HPSJ has also extended […]
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October 2018 – Claims corner newsletter
October 8, 2018 / by HPSJ / Alerts, Claims Corner
Opioid 7-Day Supply Limit for Initial Fill Effective 12/1/2018, all initial fills of opioid prescriptions will be limited to a seven (7) day supply. To reduce the potential for chronic opioid use or misuse, HPSJ is implementing this safety limit on initial opioid prescription fills for treatment of acute pain. This is based on the […]
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September 2018 – Claims corner newsletter
September 9, 2018 / by HPSJ / Alerts, Claims Corner
HPSJ Member ID# All claims billed for HPSJ members must be billed with their HPSJ member ID#. The ID# starts with 200. Claims submitted with the MCL CIN# will be rejected as “member unknown.” HPSJ member eligibility can be verified through the provider portal New born claims Physician services for the care of the newborn […]
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