September 18, 2024 / by HPSJ / Alerts
Date: September 17, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers, Facilities and Hospitals Type: Informational Subject: Dignity Health Termination Business: Medi-Cal Managed Care As we communicated previously, Dignity Health issued a notice of termination, which included St. Joseph’s Medical Center, Mercy Medical Center, and Dignity Health [...]
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Health Plan of San Joaquin provider Alerts
Implementation of Automated 835 Files
September 30, 2024 / by HPSJ / Alerts
Date: September 30, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers Type: Informational Subject: Implementation of Automated 835 Files Business: Medi-Cal Managed Care Health Plan is pleased to announce an important update to the distribution process of the 835 Electronic Remittance Advice (ERA) files. We now have [...]Read more
Medical Benefit Updates
September 30, 2024 / by HPSJ / Alerts
Date: September 30, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Practitioners and Facilities Type: Formulary Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective December 9, 2024 the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code J3490 – INJECTION, SULBACTAM/DURLOBACTAM, (XACDURO): [...]Read more
2024 Provider Appointment Availability Survey (PAAS)
September 27, 2024 / by HPSJ / Alerts
Date: September 27, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Primary Care Providers, Specialists, Behavioral Health Providers, and Ancillary Providers Type: Regulatory Subject: 2024 Provider Appointment Availability Survey (PAAS) Business: Medi-Cal Managed Care Health Plan is required by the Department of Health Care Services (DHCS) to monitor [...]Read more
Behavioral Healthcare Services – Claims and Disputes
September 26, 2024 / by HPSJ / Alerts
Date: September 26, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Primary Care Providers, Specialists, Behavioral Health Providers, and Ancillary Providers Type: Regulatory Subject: Behavioral Healthcare Services – Claims and Disputes Business: Medi-Cal Managed Care As a reminder to all Health Plan providers, as of October 1, 2024, [...]Read more
Update: Children’s Presumptive Eligibility
September 25, 2024 / by HPSJ / Alerts
Date: September 25, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers Type: Regulatory Subject: Update: Children’s Presumptive Eligibility Business: Medi-Cal Managed Care As recently communicated by Health Plan and in accordance with the Department of Health Care Services (DHCS), effective July 1, 2024, the Child Health and [...]Read more
Claims Editing System (CES)- Quarterly Update
September 25, 2024 / by HPSJ / Alerts
Date: September 20, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers and Practitioners Type: Regulatory Subject: Claims Editing System (CES)- Quarterly Update Business: Medi-Cal Managed Care We recently notified you that Health Plan implemented a Claims Editing System (CES) on April 1, 2024. As the system has [...]Read more
Department of Health Care Services (DHCS) Summits on Harm Reduction in Substance Use Disorder (SUD) Treatment
September 20, 2024 / by HPSJ / Alerts
Date: September 18, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers and Facilities Type: Informational/Educational Subject: Department of Health Care Services (DHCS) Summits on Harm Reduction in Substance Use Disorder (SUD) Treatment Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) is excited to announce [...]Read more
Reminder: Initial Health Appointments (IHA)
September 20, 2024 / by HPSJ / Alerts
Date: September 18, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers and Facilities Type: Informational/Educational Subject: Reminder: Initial Health Appointments (IHA) Business: Medi-Cal Managed Care The following alert is a reminder regarding Initial Health Appointments (IHA): Health Plan members must be seen for an Initial Health Appointment [...]Read more
Update: Justice-Involved Live Webinars
September 20, 2024 / by HPSJ / Alerts
Date: September 18, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers Type: Informational Subject: Update: Justice-Involved Live Webinars Business: Medi-Cal Managed Care As recently communicated by Health Plan, Medi-Cal’s Outreach and Education Department, along with the Department of Health Care Services (DHCS), are offering Justice-Involved Live Webinars. [...]Read more
Dignity Health Termination
September 18, 2024 / by HPSJ / Alerts
Date: September 17, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers, Facilities and Hospitals Type: Informational Subject: Dignity Health Termination Business: Medi-Cal Managed Care As we communicated previously, Dignity Health issued a notice of termination, which included St. Joseph’s Medical Center, Mercy Medical Center, and Dignity Health [...]Read more