Referrals

An HPSM-contracted PCP can refer patients to:

• HPSM-contracted specialists without prior authorization using your office's referral process (for ACE members, please use the ACE referral authorization form)
• Specialists outside of HPSM’s network if an appropriate in-network specialist is not available
• Dental referrals can be made by using our dental referral form or by calling 650-616-1522
  

To refer to a non-network specialist:

• Identify and make a referral to the specialist using your own office's referral process. 
• The non-network specialist must then submit a prior authorization form for any services rendered, including regular office visits. The prior authorization request will be reviewed by HPSM and the decision will be communicated to the out-of-network specialist. Click here for review response times. 
• Upon authorization, the specialist can move forward with providing care to the member.