Health Plan of San Joaquin provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.hpsj.com/providers |
|---|---|
| Payer contact reference | 1-888-936-7526 |
| Claims payer ID | Select HPSJ/MVHP Medi-Cal or Advantage D-SNP resources for the member before identifying claim routing and the responsible administrator. |
| Eligibility payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Health Plan of San Joaquin. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| Timely filing | 365 days (verify applicability) |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- This registry has not established a payer-specific appeal ladder for Health Plan of San Joaquin. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
- This registry has not established one national ERA payer ID for Health Plan of San Joaquin. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment.
Health Plan of San Joaquin at a glance
| Legal name | Health Plan of San Joaquin |
|---|---|
| Also known as | HPSJ |
| Category | Medicaid MCO |
| Parent organization | Health Plan of San Joaquin |
| Claims payer ID | Select HPSJ/MVHP Medi-Cal or Advantage D-SNP resources for the member before identifying claim routing and the responsible administrator. |
| Eligibility (270/271) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Health Plan of San Joaquin. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| NAIC company code | Not established in this registry |
| States covered | California |
| Provider resource entry point | https://www.hpsj.com/providers |
| Provider phone | 1-888-936-7526 |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Health Plan of San Joaquin
This registry lists 365 days as an initial-claim reference for Health Plan of San Joaquin. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
| Submission type | Window |
|---|---|
| Initial claim reference | 365 days (verify applicability) |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Health Plan of San Joaquin. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Health Plan of San Joaquin provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Health Plan of San Joaquin
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Health Plan of San Joaquin electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Health Plan of San Joaquin. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Health Plan of San Joaquin
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Health Plan of San Joaquin volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | Select HPSJ/MVHP Medi-Cal or Advantage D-SNP resources for the member before identifying claim routing and the responsible administrator. |
| 270 / 271 eligibility | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Health Plan of San Joaquin. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
portal_url
Source comparison: 2026-09-26
Current HPSJ/MVHP public provider resource and portal links were directly retrieved.
Primary source for portal_urlpayer_ids.claims
Source comparison: 2026-09-26
Current provider resources separate Medi-Cal andAdvantageD-SNP. A single blank claim ID cannot be populated from portal availability alone.
Primary source for payer_ids.claims
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; provider_phone: Stored 888-936-7526 appears labeled Medi-Cal application assistance in the FAQ footer. Provider claims role needs separate evidence; do not renew it as a universal provider line.; record_scope: Not verified by the retrieved sources in this bounded comparison; retain explicit uncertainty and do not infer from another field or organization.; timely_filing_days: Not verified by the retrieved sources in this bounded comparison; retain explicit uncertainty and do not infer from another field or organization.; payer_ids.eligibility / payer_ids.era / era_payer_id: No current transaction-specific eligibility/ERA identifier evidence was verified; do not reuse claim identifiers.; electronic_claims_supported / supports_279_271 / supports_278: Not verified by the retrieved sources in this bounded comparison; retain explicit uncertainty and do not infer from another field or organization.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: Not verified by the retrieved sources in this bounded comparison; retain explicit uncertainty and do not infer from another field or organization..
Sources used for this guide
State coverage
Health Plan of San Joaquin operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Health Plan of San Joaquin
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Health Plan of San Joaquin; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Health Plan of San Joaquin; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Health Plan of San Joaquin before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Health Plan of San Joaquin
Where is the Health Plan of San Joaquin provider portal?
Use https://www.hpsj.com/providers as a starting point for Health Plan of San Joaquin provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Health Plan of San Joaquin?
This registry lists 365 days as an initial-claim reference for Health Plan of San Joaquin. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
Does Health Plan of San Joaquin publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Health Plan of San Joaquin. Claims: Select HPSJ/MVHP Medi-Cal or Advantage D-SNP resources for the member before identifying claim routing and the responsible administrator.. Eligibility (270/271): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. ERA (835): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Health Plan of San Joaquin. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment.. Do not substitute a claims ID for an unverified transaction ID. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Health Plan of San Joaquin accept electronic claims?
Verify Health Plan of San Joaquin electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Health Plan of San Joaquin denial?
This registry has not established a payer-specific appeal ladder for Health Plan of San Joaquin. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Health Plan of San Joaquin prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Health Plan of San Joaquin provider phone number?
This registry lists 1-888-936-7526 as a contact reference for Health Plan of San Joaquin. Confirm the number and service scope against the member ID card and current product-specific directory; claims, eligibility and authorization inquiries may use different teams.
Automate workflows around Health Plan of San Joaquin requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Health Plan of San Joaquin's current published documents before submission. CPT® is a registered trademark of the American Medical Association.