July 12, 2024 / by HPSJ / Alerts
Date: July 12, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: Jiva System Downtime Business: Medi-Cal Managed Care ZeOmega, the organization providing the Jiva platform via the Cloud, will conduct their annual Disaster Recovery (DR) exercise on Saturday, July 13, 2024. During this time, [...]
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Health Plan of San Joaquin provider Alerts
Announcement for Behavioral Healthcare Services
August 12, 2024 / by HPSJ / Alerts
Date: August 07, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Practitioners Type: Informational/Educational Subject: Announcement for Behavioral Healthcare Services Business: Medi-Cal Managed Care This alert is to inform all Health Plan providers that as of October 1, 2024, all behavioral healthcare services will be managed [...]Read more
Newborn Gateway Launched in July 2024
August 12, 2024 / by HPSJ / Alerts
Date: August 07, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Regulatory Subject: Newborn Gateway Launched in July 2024 Business: Medi-Cal Managed Care In accordance with the Department of Health Care Service (DHCS) publication, effective July 1, 2024, Assembly Bill 118, Chapter 42, Statutes of 2023, [...]Read more
CHDP is Rebranded as Children’s Presumptive Eligibility
August 12, 2024 / by HPSJ / Alerts
Date: August 07, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Regulatory Subject: CHDP is Rebranded as Children’s Presumptive Eligibility Business: Medi-Cal Managed Care In accordance with the Department of Health Care Service (DHCS) publication, effective July 2024, the Child Health and Disability Prevention (CHDP) Gateway has [...]Read more
Reminder: Enhanced Provider Dispute Resolution (PDR) Process
July 24, 2024 / by HPSJ / Alerts
Date: July 24, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Facilities Type: Educational/ Informational Subject: Reminder: Enhanced Provider Dispute Resolution (PDR) Process Business: Medi-Cal Managed Care On April 15, 2021, Health Plan implemented several new enhancements to the PDR process. This alert serves as a [...]Read more
FDA Drug Recall – Acetaminophen Injection, 1000mg/100mL
July 24, 2024 / by HPSJ / Alerts
Date: July 24, 2024 From: Health Plan Pharmacy Department To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Physicians and Providers Type: Formulary Subject: FDA Drug Recall - Acetaminophen Injection, 1000mg/100mL Business: Medi-Cal Managed Care Health Plan would like to inform you there has been a recent recall on the medication Acetaminophen Injection, [...]Read more
Pregnancy Care Office Visit: Antepartum Initial
July 14, 2024 / by HPSJ / Alerts
Date: July 10, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Obstetric Care Providers Type: Regulatory Subject: Pregnancy Care Office Visit: Antepartum Initial Business: Medi-Cal Managed Care Please review the following Medi-Cal (MCL) billing guidelines for proper claim submission and reimbursement for initial antepartum visits. Pregnancy Care Office [...]Read more
Ultrasound During Pregnancy
July 14, 2024 / by HPSJ / Alerts
Date: July 10, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Obstetric Care Providers and Diagnostic Radiologists Type: Regulatory Subject: Ultrasound During Pregnancy Business: Medi-Cal Managed Care Please review the following Medi-Cal (MCL) billing guidelines for proper claim submission and reimbursement for ultrasound during pregnancy services. Ultrasound During [...]Read more
Medical Benefit Updates
July 14, 2024 / by HPSJ / Alerts
Date: July 10, 2024 From: Health Plan Pharmacy and Therapeutics Committee To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Physicians Type: Regulatory Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective September 16, 2024, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code J3358 [...]Read more
Update to Changes to Prior Authorization Requirements for Physical Therapy Visits
July 14, 2024 / by HPSJ / Alerts
Date: July 10, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Facilities Type: Informational/Regulatory Subject: Update to Changes to Prior Authorization Requirements for Physical Therapy Visits Business: Medi-Cal Managed Care To improve member access to services and provider experience, Health Plan is implementing a change to [...]Read more
Jiva System Downtime
July 12, 2024 / by HPSJ / Alerts
Date: July 12, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: Jiva System Downtime Business: Medi-Cal Managed Care ZeOmega, the organization providing the Jiva platform via the Cloud, will conduct their annual Disaster Recovery (DR) exercise on Saturday, July 13, 2024. During this time, [...]Read more