Providers

Section 1: About HPSM Section 2: Customer Support Section 3: Member Complaints Section 4: Claims Section 5: Provider Disputes Section 6: Ancillary Services Section 7: Utilization Management Section 8: Provider Services Section 9: Quality Improvement Section 10: Health Education Section 11: Fraud Waste and Abuse Section 12: Privacy

Clinical Guidelines Language Assistance Services

Cultural Competency Get a Phone or Video Interpreter Get Translated Member Materials Health Literacy Language Documentation Requirements Language Training & Resources Provider Language Assistance Checklist

Provider Forms

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Directory Search Formulary Search Diabetes Prevention Program

End of Life Care Grievance & Appeals Process

What is a complaint? Providers’ responsibilities Response timeframes Contact HPSM's G&A Unit

Healthcare Effectiveness Data and Information Set Home Health Care Initial Health Assessment Maternal Care Medical Record and Facility Site Reviews Member Handbooks Newsletters Pediatric Care Potential Quality Issues Urgent Care Tobacco Prevention and Cessation Services Older Adults and Persons with Disabilities Provider Videos

Care Coordination Value Based Payment Program

Primary Care Provider Incentive

Program Guidelines Feedback

Nursing Facility Incentive Ob-Gyn Incentive Specialists Incentive

Learning Lab

HPSM Dental Providers

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HPSM Dental Application

Dental Provider Payments Covered Dental Services Benefits of Dental Integration HPSM Dental Mission An Innovative Pilot Program

Behavioral Health News & Updates

Urgent Messages Prepare for Power Shutoffs

Provider Portal / eReports CalAIM at HPSM Provider Contacts

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