Questions about COVID-19
Questions about COVID-19
Medi-Cal Evidence of Coverage EOC
Questions about COVID-19
Questions about COVID-19
Long Term Care Services & Support
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Long Term Care Services & Support

Effective January 1, 2024, or as authorized by the Department of Health Care Services, Long Term Care: ICF DD/DH/DD-N and Sub-Acute will be carved in for HPSJ.

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The San Joaquin County Health Commission announced that it will expand operations to El Dorado and Alpine Counties, effective January 1, 2024. Read the full media release HERE

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Your new 2024 Evidence of Coverage (EOC) is available

The EOC contains information about access and care, benefits and services, language support, claims, and complaints and appeals.

You can now download or view a copy online!

HEDIS

COMING SOON: Inovalon Value Compass Provider Portal

As of July 1, 2023 HPSJ’s HEDIS Care Gap Provider Portal has sunset. Access to this portal is no longer available.

HPSJ is working with our new HEDIS vendor, Inovalon, to build our new Provider Portal. Please keep an eye out for future Provider Alerts and Communications about:

· Official Launch Date

· Live Training Availability

· Training Videos and Guides

· AND MORE!

As we work to transition to the new portal, you can reach out to your Provider Services Representative by calling our Customer Service Department at 1-888-936-7526 or you may e-mail HEDIS@hpsj.com to request a copy of the latest gap lists for your office.

Medi-Cal Beneficiaries

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Medi-Cal renewals are here, are your patients informed?

MEDICAL

MEDI-CAL

MEDI-CAL BENEFICIARIES

MEDI-CAL BENEFICIARIES

MEDI-CAL BENEFICIARIES

PlanScan

The Summer 2023 digital edition of PlanScan is now available!

Stay informed and up-to-date with PlanScan by Health Plan of San Joaquin.

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ProviderManual

Provider Manual

The 2023 Provider Manual is now available

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Notable Updates:
- Continuity of Care
- Long-Term Care
- Provider Preventable Conditions (PPC)

February

covid19

Questions about Coronavirus (COVID-19)?

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DRE Login

Provider, please sign in:

Reset password or reactivate an account

Provider Network

Are you interested in becoming a contracted provider?
Click Here to Learn More
customer service

Customer Service Representatives are available to assist you Monday-Friday from 8:00 a.m. - 5:00 p.m.

my rewards

Our Member Incentive Program myRewards was designed to support California's Manged Care Accountability Set (MCAS)

DRE portal

Preauthorization Training Material

Provider Portal

HPSJ's new electronic Medical Management System - the enhanced DRE Provider Portal

NCQA

NCQA Acreditation

The National Committee for Quality Assurance (NCQA) has awarded HPSJ a Three-Year Accreditation for Medicaid HMO for our Medi-Cal line of business.

medical technology

Medical Technology Approval

To request consideration for approval of New Medical Technology please contact the Director of Care Management at 209.469.8384.

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Posted on October 21st, 2022 and last modified on April 6th, 2023.

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