Authorization Requirement
New CareAdvantage Inpatient Admission Prior Authorization Requirement for Elective Admissions
Effective with date of service April 5, 2010, all hospital providers requesting
Diagnosis Related Group (DRG) reimbursement for any elective Health Plan
of San Mateo (HPSM) Care Advantage member acute inpatient admission
will require prior authorization from HPSM.
CareAdvantage Inpatient Authorization Request Form.
Prior authorization requests should be faxed to 650-829-2079 or sent via US Mail to:
Health Plan of San Mateo
Attn: Health Services
701 Gateway Blvd. #400
South San Francisco, CA 94080
Please note elective inpatient admissions will not be processed at the DRG reimbursement rate without prior authorization.
For all emergency admissions, hospital providers should continue to submit face sheets to HPSM via fax at 650-829-2060.
If you have any questions, please contact HPSM’s Provider Services Department at
650-616-2106 or Health Services at 650-616-2070.