July 22, 2016 / by HPSJ / Alerts
Date: July 22, 2016 To: HPSJ Primary Care Physicians, Pediatricians, OBGyn’s From: Provider Services Department Subject: Provider Alert – Z3A Diagnosis Category Information Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) We understand the importance of a healthy pregnancy. Health education information and resources can support and encourage a successful pregnancy. HPSJ would […]
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Health Plan of San Joaquin provider Alerts
Changes to Prior Authorization Requirements
July 22, 2016 / by HPSJ / Alerts
Date: July 22, 2016 To: HPSJ Primary Care Physicians, Pediatricians, OBGyn’s From: Provider Services Department Subject: Changes to Prior Authorization Requirements Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Our HPSJ network providers are important partners in delivering care to our members. As we continue to seek ways to streamline processes, HPSJ has […]
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Z3A Diagnosis Category Information
July 22, 2016 / by HPSJ / Alerts
Date: July 22, 2016 To: HPSJ Primary Care Physicians, Pediatricians, OBGyn’s From: Provider Services Department Subject: Provider Alert – Z3A Diagnosis Category Information Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) We understand the importance of a healthy pregnancy. Health education information and resources can support and encourage a successful pregnancy. HPSJ would […]
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Access Standards for Appointments
July 15, 2016 / by HPSJ / Alerts
Date: July 15, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Access Standards for Appointments Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Recently, Health Plan of San Joaquin (HPSJ) sponsored a survey on the subject of timely access for appointments. Our results revealed that not all […]
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Formulary Update – Health Plan of San Joaquin (HPSJ) Physicians and Providers
June 27, 2016 / by HPSJ / Alerts
Date: June 14, 2016 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update – Health Plan of San Joaquin (HPSJ) Physicians and Providers Business: Medi-Cal, AIM Effective by 8/16/2016, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the […]
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REMINDER – Billing for Non-Physician Practitioners
June 27, 2016 / by HPSJ / Alerts
Date: June 15, 2016 To: Health Plan of San Joaquin (HPSJ) PCPs, Providers and Practice Billing Managers From: Provider Services Department Subject: REMINDER – Billing for Non-Physician Practitioners Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) To decrease the amount of claim denials to providers and incoming disputes to HPSJ, the following guidance is […]
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Community Health Education and Engagement Referral (CHEER) Program
June 22, 2016 / by HPSJ / Alerts
Date: June 22, 2016 To: HPSJ Primary Care Physicians and Partner Organizations From: Provider Services Department Subject: Community Health Education and Engagement Referral (CHEER) Program Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) An effective health education system is essential to promoting HPSJ member involvement in health care decisions, effective use of healthcare […]
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NEW – DRE Quality Incentive Dashboard
June 22, 2016 / by HPSJ / Alerts
Date: June 22, 2016 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Provider Services Department Subject: NEW – DRE Quality Incentive Dashboard Business: Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) Health Plan of San Joaquin (HPSJ) is pleased to announce the launch of the new Quality Incentive Dashboard, located in […]
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Update – Refining Continues for System Identification for fraud, waste and abuse capture, as well as claims editing
June 22, 2016 / by HPSJ / Alerts
Date: June 22, 2016 To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Update – Refining Continues for System Identification for fraud, waste and abuse capture, as well as claims editing Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) There is nothing providers need to do, beyond what your practice […]
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J code Medications – Carved-Out to Fee-for-Service (FFS) Medi-Cal
May 16, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers and Hospitals From: Provider Services Department Subject: J code Medications – Carved-Out to Fee-for-Service (FFS) Medi-Cal Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective July 14, 2016. Certain J code medications are carved-out and should be billed directly to FFS Medi-Cal. In order to determine […]
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Provider Network Demographics and Data Validation Project (Practice)
May 12, 2016 / by HPSJ / Alerts
Date: May 12, 2016 To: Health Plan of San Joaquin (HPSJ) Provider Facilities From: Provider Services Department Subject: Provider Network Demographics and Data Validation Project Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) As you may know, California lawmakers have passed legislation to improve the experience of healthcare consumers. As of July 1, 2016, […]
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