Health Plan of San Joaquin provider Alerts

Courtesy Message – Additional Information

Date: February 21, 2017 To: Third Party Administrator (TPA) Contracted Providers From: San Joaquin Health Administrators (SJHA) Subject: Courtesy Message – Additional Information Business: TPA Effective March 1, 2017 As a courtesy, we want to make you aware that effective March 1, 2017, SJHA (San Joaquin Health Administrators) will no longer provide TPA (Third Party […]

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Coming – Spring 2017 Enhanced DRE Service for HPSJ Provider Network

Date: February 8, 2017 To: Health Plan of San Joaquin (HPSJ) Providers and Practitiones From: HPSJ Medical Management & IT Departments Subject: Coming – Spring 2017 Enhanced DRE Service for HPSJ Provider Network Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Coming – Spring 2017 Enhanced DRE Service for HPSJ Provider Network As […]

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HEDIS Time: Annual Medical Records Review

Date: February 1, 2017 To: Health Plan of San Joaquin (HPSJ) Providers and Practitioners From: Medical Management Department – Health Plan of San Joaquin Subject: HEDIS Time: Annual Medical Records Review Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Traditionally scheduled for February through May of each year, the 2017 Medical Review Process […]

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Effective 2/21/2017, the Pharmacy and Therapeutics Committee has approved the following changes:

Date: December 21, 2016 To: Health Plan of San Joaquin (HPSJ) Providers and Practitioners From: HPSJ Medical Management Department Subject: Comprehensive Tobacco Cessation Services Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Additions to the Formulary: Potassium Citrate ER 15 mEq (Urocit-K): No PA required. Alemtuzumab (Lemtrada): PA required. Restricted to neurologists. Documented diagnosis […]

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REMINDER: Coordination of care Between Emergency Departments and Primary Care Physicians (PCPs)

Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Emergency Department Providers From: HPSJ Medical Management Department Subject: REMINDER: Coordination of care Between Emergency Departments and Primary Care Physicians (PCPs) Business: Medi-Cal Emergency Department Partners: This is a reminder to our contracted acute care hospital Emergency Departments of the importance of the coordination of […]

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REMINDER: Coordination of Care Between Hospitals and Primary Care Physicians (PCPs)

Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Hospital Providers From: HPSJ Medical Management Department Subject: REMINDER: Coordination of Care Between Hospitals and Primary Care Physicians (PCPs) Business: Medi-Cal Hospital Partners: This is a reminder to our contracted acute care hospitals of the importance of the coordination of care between hospitals and the […]

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Medical Necessity Reviews Change & Prior Authorization Requests Reminder

Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Medical Management Departmentt Subject: Medical Necessity Reviews Change & Prior Authorization Requests Reminder Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) strives to maintain, update and educate on the guidelines set forth by Medi-Cal (MCAL), […]

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Affirmative Statement about Utilization Management Incentives – REMINDER

Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Medical Management Department Subject: Affirmative Statement about Utilization Management Incentives – REMINDER Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) The mission of Health Plan of San Joaquin is to continuously improve the health of our community. HPSJ supports its […]

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REMINDER: Coordination of Care Between Skilled Nursing Facilities (SNF) and Primary Care Physicians (PCPs)

Date: December 19, 2016 To: Health Plan of San Joaquin (HPSJ) Providers and Practitioners From: HPSJ Medical Management Department Subject: REMINDER: Coordination of Care Between Skilled Nursing Facilities (SNF) and Primary Care Physicians (PCPs) Business: Medi-Cal Skilled Nursing Facility Partners: This is a reminder to our contracted Skilled Nursing Facilities of the importance of the coordination […]

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