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