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Claims
HPSM Dental Providers
Submit Claims
Rebill, Correct or Update Claims
Submit a Claims Dispute or Appeal
Get Paid Faster with EFT/ERA
Contact Claims Services
Provider Resources
Provider Manual
Care Coordination
Value Based Payment Program
Learning Lab
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
Directory Search
Formulary Search
Member Handbooks
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Maternal Care
Pediatric Care
Urgent Care
End of Life Care
Diabetes Prevention Program
Seniors and Persons with Disabilities
Initial Health Assessment
Tobacco Prevention and Cessation Services
Healthcare Effectiveness Data and Information Set
Potential Quality Issues
Medical Record and Facility Site Reviews
Grievance & Appeals Process
Join HPSM Dental
Dental Provider Payments
Covered Dental Services
Benefits of Dental Integration
HPSM Dental Mission
An Innovative Pilot Program
Behavioral Health
News & Updates
Provider Portal / eReports
CalAIM at HPSM
Provider Contacts
All Provider Tasks
Get Translated Member Materials
HPSM provides member materials at no cost that are:
- Translated into five languages (English, Spanish, Chinese, Tagalog or Russian)
- Available in alternate formats (such as large print, Braille or audio)
To order materials in an HPSM member’s preferred language or alternative format, please contact Provider Services.
Provider Services
Toll free: 1-833-694-7761 Local: 650-616-2106
Fax: 650-616-8046
Monday 1:00 p.m. to 5:00 p.m. Tuesday–Friday 8:00 a.m. to 5:00 p.m.
Email: psinquiries@hpsm.org
ACE Program Benefits Quick-Start Guide
ACE Program Fee Waiver Quick-Start Guide
CareAdvantage 2021 Benefits Quick-Start Guide
CareAdvantage 2021 Summary Of Benefits
CareAdvantage 2022 Summary Of Benefits
CareAdvantage 2022 Member Handbook
CareAdvantage 2022 Provider Directory
CareAdvantage 2022 Formulary
HealthWorx HMO Benefits Quick-Start Guide
HealthWorx HMO Evidence of Coverage
HealthWorx HMO Summary of Benefits
HealthWorx HMO Provider Directory
Medi-Cal Benefits Quick-Start Guide
Medi-Cal Member Handbook / Evidence of Coverage
Medi-Cal Provider Directory
San Mateo County ACE Participant Handbook
San Mateo County ACE Provider List
Guía de inicio rápido del programa ACE
Guía de inicio rápido de exoneración de cuotas del Programa ACE
CareAdvantage Guía de beneficios de inicio rápido
CareAdvantage 2021 Resumen de Beneficios
CareAdvantage 2022 Resumen de Beneficios
CareAdvantage 2022 Manual para los Miembro
CareAdvantage 2022 Directorio de proveedores y farmacias
CareAdvantage 2022 Formulario (lista de medicamentos cubiertos)
Guía de inicio rápido de beneficios de HealthWorx HMO
HealthWorx HMO Evidencia de Cobertura
HealthWorx HMO Resumen de Beneficios
HealthWorx HMO Directorio de proveedores y farmacias
Guía de inicio rápido de beneficios de Medi-Cal
Manual del Miembro de Medi-Cal
Medi-Cal directorio de proveedores y farmacias
ACE Manual del Participante
San Mateo County ACE Lista de Proveedores
CareAdvantage 福利快速入門指南
CareAdvantage 2021 福利摘要
CareAdvantage 2022 福利摘要
CareAdvantage 2022 會員手冊 (快來了)
CareAdvantage 2022 服務提供者及藥房名錄
CareAdvantage 2022 承保藥物清單(處方集)
HealthWorx HMO 計劃 福利快速入門指南
HealthWorx HMO 會員手冊及承保說明書
HealthWorx HMO 福利及承保摘要
HealthWorx HMO 服務提供者及藥房名錄
Medi-Cal 加州低收入醫療保險 (白卡) 福利快速入門指南
Medi-Cal 會員手冊及承保說明書
Medi-Cal 服務提供者及藥房名錄
CareAdvantage Maikling Gabay sa Pagsisimula Tungkol sa Mga Benepisyo
CareAdvantage 2021 Buod ng Mga Benepisyo
CareAdvantage 2022 Buod ng Mga Benepisyo
CareAdvantage 2022 Aklat-Gabay ng Miyembro (malapit na)
CareAdvantage 2022 Direktoryo ng Tagabigay ng Serbisyo at Parmasiya
CareAdvantage 20221 Pormularyo (listahan ng mga sakop na gamot)
Gabay sa Mabilis na Pagsisimula sa Mga Benepisyo ng HealthWorx HMO
HealthWorx HMO Aklat-Gabay ng Miyembro at Katibayan ng Pagkakasakop
HealthWorx HMO Buod ng Mga Benepisyo
HealthWorx HMO Direktoryo ng Tagabigay ng Serbisyo at Parmasiya
Gabay sa Mabilis na Pagsisimula sa Mga Benepisyo ng Medi-Cal
Medi-Cal Aklat-Gabay ng Miyembro at Katibayan ng Pagkakasakop
Medi-Cal Direktoryo ng Tagabigay ng Serbisyo at Parmasiya