Provider Portal 

Provider Portal

  • Verify members’ eligibility
  • Check claims payment
  • Submit prior authorization requests and check request status
  • Sign up for and update Electronic Funds Transfer/Electronic Remittance Advice (EFT/ERA)
  • Existing users login here
  • New user? Register here or by calling 650-616-2106.

Submit claims online

  • Submit CMS-1500 format claims online here
  • New user? Register here to submit online CMS-1500 format claims
  • Please note: HPSM currently accepts electronic claims from two different clearinghouses, Office Ally (Payer ID: HPSM1) and Change Healthcare (Payer ID: SX174 for 837 professional & 12X74 for 837 Institutional). UB04 (Institutional) claims can only be submitted through FTP, Office Ally or Change Healthcare. 1500 claim submissions are accepted through eHealthsuite, Office Ally, or Change Healthcare.

eReports

  • Remittance advices
  • PCP and Nursing Facility Value-Based Payment Program reports
  • Personalized patient engagement data for PCPs
  • Primary care panel assignment and capitation reports
    • Existing users login here
    • New user? Sign up for eReports by calling 650-616-2106

Update My Information

Use this form to verify that your information in HPSM's provider directory is correct, or to submit a change to your directory information.


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