Question about a claim?

Claims Services

Call 650-616-2056
Monday, Tuesday, Thursday & Friday – 8:00 a.m. to 5:00 p.m. (closed 12:00 p.m. to 1:00 p.m.)
Wednesday – 8:00 a.m. to 12:00 p.m.

Or email ClaimsInquiries@hpsm.org
Email confirmation sent by next business day

Member Eligibility

To check a member’s PCP assignment, and verify eligibility, providers should call HPSM’s 24-hour Automated Eligibility Verification System (AEVS) at 1-800-696-4776 and follow the automated instructions.

Member eligibility can also be checked via HPSM’s Provider Portal once a User ID and Password have been established. Please call 650-616-2106 for assistance.

Authorization Fax Numbers

HPSM has several direct fax lines dedicated to specific form submissions:

In-patient admissions with facesheet for all lines of business (including in-patient retros and corrections): 

650-829-2060

In-patient admissions, clinicals only (without facesheet)

650-829-2068

Out-patient retro authorizations and corrections

650-829-2062

PCP referrals for Behavioral Health and Recovery Services

650-596-8065

Pharmacy authorizations and modifications to formulary

650-829-2045

CBAS and MSSP referrals, Care Coordination

650-829-2047

When including clinicals:

  • Place the facesheet before any clinical information
  • Do not submit observation requests: observation status is direct billable
  • Do not submit requests for services delivered in the emergency room: these are direct billable