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Submit a Claims Dispute or Appeal
Get Paid Faster with EFT/ERA
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Provider Incentive Programs
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 Interpreter Services
Translated & Alternative Format Member Materials
Language Documentation Requirements
Language Training and Resources
Provider Forms
Directory Search
Formulary Search
Diabetes Prevention Program
End of Life Care
Grievance & Appeals Process
Healthcare Effectiveness Data and Information Set
Home Health Care
Initial Health Appointment
Maternal Care
Medical Record and Facility Site Reviews
Member Handbooks
HEALTHmatters MD
Pediatric Care
Potential Quality Issues
Urgent Care
Tobacco Cessation Information and Resources
Identifying Tobacco Users
Treating Patients Who Use Tobacco
Vulnerable Populations
Provider Education and Trainings
Older Adults and People with Disabilities
Provider Videos
Remote Patient Monitoring
Incentives for Primary Care Providers
Incentives for Nursing Facilities
Incentives for Specialty Providers
Learning Lab
SB855 Training Request
HPSM Dental Providers
Join HPSM Dental
Dental Provider Payments
Covered Dental Services
Benefits of Dental Integration
HPSM Dental Mission
An Innovative Pilot Program
Patient Experience
Contact Claims Department
Claims Services
Medical and dental claims: 650-616-2106
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.
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.