Claims
Claims Coding and Submission Guidelines
ADA Dental Claim Form 2019 Version
(715 KB)
Claims Submission CMS UB-04
(35 KB)
Claims Submission CMS1500
(37 KB)
Claims and Encounter Data Submission
(234 KB)
Sign up for Electronic Funds Transfer/Electronic Remittance Advice
EFT and ERA are fast, secure and more accurate than paper checks.
- Electronic Funds Transfer (EFT) sends claims payments directly to your bank account
- Electronic Remittance Advice (ERA) makes it easier to access and reconcile payment information
Contact psinquiries@hpsm.org with any questions.