March 8, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Zika Virus Provider Alert Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Zika virus is the latest serious, international threat to public health. While it raises many questions, we currently have few answers. For the coming months, Zika likely will remain […]
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Health Plan of San Joaquin provider Alerts
Provider Network Demographics and Data Validation Project (Facilities)
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 Alert – Provider Network Demographics and Data Validation Project (Facilities) 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 […]
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ADVICE – Correcting CMS-1500 Claims Submissions Also, when NOT to submit a dispute
April 22, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) PCPs, Providers and Practice Billing Managers From: Provider Services Department Subject: ADVICE – Correcting CMS-1500 Claims Submissions Also, when NOT to submit a dispute Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) This advice is offered to help providers with the proper ways to resubmit claims – […]
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Provider Network Demographics and Data Validation Project
April 13, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers 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, new regulatory standards will be […]
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ADVICE – Proper use of billing modifiers 25 and 59
April 11, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) PCPs, Providers and Practice Billing Managers From: Provider Services Department Subject: ADVICE – Proper use of billing modifiers 25 and 59 Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) To advise providers on the proper use of modifiers 25 and 59 – and to decrease the amount […]
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Provider Alert Formulary Update – 5/20/2016
April 11, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Provider Alert Formulary Update – 5/20/2016 Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective 5/20/2016, the Pharmacy and Therapeutics Committee has approved the following changes: Additions to the Formulary: Oral Contraceptives (no […]
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Prenatal and Postpartum Provider Incentives
March 22, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Prenatal and Postpartum Provider Incentives Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) HPSJ is pleased to announce 2016 Provider incentives for prenatal and postpartum care. This provider incentive is valid from January 1, 2016 through December 31, 2016. The $25 incentive is […]
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Changes to Prior Authorization Requirements – CT Scans, Ultrasounds and Mammograms
March 8, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Changes to Prior Authorization Requirements – CT Scans, Ultrasounds and Mammograms Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Effective June 15, 2016. Our providers are important partners in delivering care to our patients. As we seek more ways to streamline […]
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Zika Virus Provider Alert
March 8, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: Zika Virus Provider Alert Business: Medi-Cal, AIM (now known as Medi-Cal Access Program) Zika virus is the latest serious, international threat to public health. While it raises many questions, we currently have few answers. For the coming months, Zika likely will remain […]
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Collaborative Asthma control improvement plan
March 7, 2016 / by HPSJ / Alerts
To: HPSJ Provider Network Primary Care Providers (PCPs) From: HPSJ Medical Management and Pharmacy Departments Subject: Collaborative Asthma control improvement plan Business: Medi-Cal, MCAP (Formerly known as AIM) You soon will receive a letter from us outlining the HPSJ Improvement Project geared specifically towards improving asthma control for our members who are your patients. We […]
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REMINDER – DHCS Reporting Requirements related to Provider-Preventable Conditions
March 7, 2016 / by HPSJ / Alerts
To: Health Plan of San Joaquin (HPSJ) Providers From: Provider Services Department Subject: REMINDER – DHCS Reporting Requirements related to Provider-Preventable Conditions Business: Medi-Cal As of July 1, 2012 the Federal Affordable Care Act (ACA) requires that providers report all Provider-Preventable Conditions (PPCs) that are associated with claims for Medi-Cal payment or with courses of […]
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