Authorization Fax Numbers
HPSM has several direct fax lines dedicated to specific form submissions:
In-patient admissions with facesheet for all lines of business (including in-patient retros and corrections): | 650-829-2060 |
In-patient admissions, clinicals only (without facesheet) | 650-829-2068 |
Out-patient retro authorizations and corrections | 650-829-2079 |
PCP referrals for Behavioral Health and Recovery Services | 650-596-8065 |
Pharmacy authorizations and modifications to formulary | 650-829-2045 |
Incontinence supply authorization: | 650-829-2079 |
CBAS and MSSP referrals, Care Coordination | 650-829-2047 |
When including clinicals:
- Place the facesheet before any clinical information
- Do not submit observation requests: observation status is direct billable
- Do not submit requests for services delivered in the emergency room: these are direct billable