Submit Claims

There are three different methods HPSM providers can use to submit claims:

  1. Paper claims submission
  2. Electronic claims submission (using standard EDI 837 format)
  3. Online using eHealthSuite (CMS-1500 format only)

Paper Claims Submission

Paper claims must be submitted on a CMS-1500 or UB-04 claims form and mailed to HPSM.

Electronic Claims Submission

Using standard EDI 837 format

  • Set up your user ID and password by calling Provider Services at 650-616-2106
  • FTP (File Transfer Protocol) to using dial-in number 650-616-8062
  • Plaintext only, migrating to 128-bit SSL encryption

Clearinghouse/Payer ID

  • Change Healthcare (formerly Emdeon and Capario)
    • For 837 Professional: SX174   
    • For 837 Institutional: 12X74
  • Office Ally: HPSM1
  • Capario: HPSM1

Provider Portal Login

Only CMS-1500 claims can be submitted through our Provider Portal at this time.

Claims Submission Instructions

For more information contact the Claims Department at 650-616-2106 or (email confirmation delivered by next business day).