September 10, 2018 / by HPSJ / Alerts
Date: September 05, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: HPSJ Claims Department Subject: Provider Alert Claim Overpayments Business: Medi-Cal For Your Information In accordance with the California Department of Health Care Services (DHCS) All Plan Letter, APL 17-003, HPSJ has implemented new auditing algorithms to identify potential overpayments […]
Read more
Health Plan of San Joaquin provider Alerts
HEDIS 2018 Member Incentives
October 24, 2018 / by HPSJ / Alerts
Please work with your patients to perform these important services by the end of the year (12/31/18). Date: October 24, 2018 To: Health Plan of San Joaquin (HPSJ) Primary Care Physicians (PCPs) From: HPSJ Medical Management Department Subject: HEDIS 2018 Member Incentives Business: Medi-Cal At HPSJ, we are your partner to improve the health and wellness […]
Read more
Reminder – Physician Certification Statement (PCS) Form
October 22, 2018 / by HPSJ / Alerts
Date: October 22, 2018 To: ealth Plan of San Joaquin (HPSJ) Practitioners and Providers From: HPSJ Medical Management Department Subject: Reminder – Physician Certification Statement (PCS) Form Business: Medi-Cal Spreading the Word, Not the Flu As we continue to seek ways to streamline processes, Health Plan of San Joaquin has simplified prior authorization requirements for […]
Read more
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 […]
Read more
Provider Alert – Formulary update effective 12/10/2018
September 27, 2018 / by HPSJ / Alerts
Date: September 27, 2018 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Provider Alert – Formulary update effective 12/10/2018 Business: Medi-Cal Effective 12/10/2018, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Abaloparatide (Tymlos) 3120mcg/1.56mL pen-injector: […]
Read more
NEW – Opioid 7-Day Supply Limit for Initial Fill
September 20, 2018 / by HPSJ / Alerts, Pharmacy Announcements
Date: September 20, 2018 To: Primary Care Providers, Specialists, Clinics, Pharmacies and Hospitals From: Health Plan of San Joaquin Pharmacy Department Subject: NEW – Opioid 7-Day Supply Limit for Initial Fill Business: Medi-Cal To reduce the potential for chronic opioid use or misuse, Health Plan of San Joaquin is implementing a safety limit on initial […]
Read more
Provider Alert – 2018-2019 Flu Season
September 14, 2018 / by HPSJ / Alerts
Date: September 13, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners and Providers From: HPSJ Medical Management Department Subject: Provider Alert – 2018-2019 Flu Season Business: Medi-Cal Spreading the Word, Not the Flu It’s official: Flu season has begun. We want to help your patients get the preventive care they need. Sometimes it can […]
Read more
Reported Sexually Transmitted Diseases Reach a New High in California
September 11, 2018 / by HPSJ / Alerts
Date: August 9, 2018 To: HPSJ Primary Care Providers, Specialists, and Pharmacies From: California Department of Public Health (CDPH) Subject: Reported Sexually Transmitted Diseases Reach a New High in California Business: Medi-Cal SACRAMENTO – A record number of Californians were diagnosed with a sexually transmitted disease (STD) in 2017, according to a new report released […]
Read more
Provider Alert Claim Overpayments
September 10, 2018 / by HPSJ / Alerts
Date: September 05, 2018 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: HPSJ Claims Department Subject: Provider Alert Claim Overpayments Business: Medi-Cal For Your Information In accordance with the California Department of Health Care Services (DHCS) All Plan Letter, APL 17-003, HPSJ has implemented new auditing algorithms to identify potential overpayments […]
Read more
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 […]
Read more
Provider Appointment Availability Survey (PAAS)
September 6, 2018 / by HPSJ / Alerts
Date: September 05, 2018 To: Health Plan of San Joaquin (HPSJ) Providers and Practitioners From: Health Plan of San Joaquin: Provider Services Subject: Provider Appointment Availability Survey (PAAS) Business: Medi-Cal Starting Today HPSJ is required to perform an annual Provider Appointment Availability Survey (PAAS), as mandated by the California Department of Managed HealthCare (DMHC). The […]
Read more