Health Plan of San Joaquin provider Alerts

Claims Editing System (CES)- Quarterly Update

Date: September 20, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers and Practitioners Type: Regulatory Subject: Claims Editing System (CES)- Quarterly Update Business: Medi-Cal Managed Care We recently notified you that Health Plan implemented a Claims Editing System (CES) on April 1, 2024. As the system has [...]

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Department of Health Care Services (DHCS) Summits on Harm Reduction in Substance Use Disorder (SUD) Treatment

Date: September 18, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers and Facilities Type: Informational/Educational Subject: Department of Health Care Services (DHCS) Summits on Harm Reduction in Substance Use Disorder (SUD) Treatment Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) is excited to announce [...]

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Reminder: Initial Health Appointments (IHA)

Date: September 18, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers and Facilities Type: Informational/Educational Subject: Reminder: Initial Health Appointments (IHA) Business: Medi-Cal Managed Care The following alert is a reminder regarding Initial Health Appointments (IHA):   Health Plan members must be seen for an Initial Health Appointment [...]

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Update: Justice-Involved Live Webinars

Date: September 18, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers Type: Informational Subject: Update: Justice-Involved Live Webinars Business: Medi-Cal Managed Care As recently communicated by Health Plan, Medi-Cal’s Outreach and Education Department, along with the Department of Health Care Services (DHCS), are offering Justice-Involved Live Webinars. [...]

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Dignity Health Termination

Date: September 17, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) To: Health Plan Providers, Facilities and Hospitals Type: Informational Subject: Dignity Health Termination Business: Medi-Cal Managed Care As we communicated previously, Dignity Health issued a notice of termination, which included St. Joseph’s Medical Center, Mercy Medical Center, and Dignity Health [...]

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Enhanced Care Management (ECM) Birth Equity Population of Focus (POF) – Live as of 01/01/2024

Date: September 11, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers, OB-GYN's, and OB Departments at all Hospitals and Facilities Type: Informational/Educational Subject: Enhanced Care Management (ECM) Birth Equity Population of Focus (POF) – Live as of 01/01/2024 Business: Medi-Cal Managed Care The ECM Birth Equity POF [...]

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Department of Health Care Services (DHCS) Integrated Core Practice Model (ICPM) and Integrated Training Guide (ITG) Sessions

Date: September 11, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers and Facilities Type: Informational/Educational Subject: Department of Health Care Services (DHCS) Integrated Core Practice Model (ICPM) and Integrated Training Guide (ITG) Sessions Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) is excited to [...]

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Justice-Involved Live Webinars

Date: September 11, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: Justice-Involved Live Webinars Business: Medi-Cal Managed Care Health Plan is happy to announce an enhancement to our EDI 837 Inbound Processing System effective September 3, 2024, aimed at improving the efficiency and accuracy [...]

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EDI 837 Inbound Processing Enhancement – Effective 9/3/2024

Date: August 28, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: EDI 837 Inbound Processing Enhancement – Effective 9/3/2024 Business: Medi-Cal Managed Care Health Plan is happy to announce an enhancement to our EDI 837 Inbound Processing System effective September 3, 2024, aimed at [...]

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Calendar Year (CY) 2024 Medi-Cal Targeted Rate Increases (TRI) and Impact to Proposition 56 Directed Payments

Date: August 28, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Fee-for-Service (FFS) Providers Type: Regulatory Subject: Calendar Year (CY) 2024 Medi-Cal Targeted Rate Increases (TRI) and Impact to Proposition 56 Directed Payments Business: Medi-Cal Managed Care Pursuant to the 2023 Budget Act and Assembly Bill (AB) 118 [...]

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