ACE Program
Obtaining an ACE Authorization
HPSM will process authorizations through its Health Services Department.
All services for Non-ACE providers must be referred by a San Mateo ACE Provider. The ACE Provider will submit a Referral Authorization Form (RAF) to HPSM for approval. Approved RAFs will be faxed to the ACE Provider as well as the referral provider.
For services that require prior authorization, the provider of service/referral provider must submit a Treatment Authorization Request (TAR). Approved TARs will be faxed to the requesting provider.
RAF and TAR forms can be found here.
Authorization requests should be faxed to HPSM’s Health Services Department at the following fax numbers:
- 650.829.2079
- 650.829.2021 Urgent
If you have any questions about an authorization request, please contact HPSM’s Health Services Department by phone at 650-616-2070.