There are three different methods HPSM providers can use to submit claims:
- Paper claims submission
- Electronic claims submission (using standard EDI 837 format)
- Online using eHealthSuite (CMS-1500 format only)
Paper Claims Submission
Paper claims must be submitted on a CMS-1500 or UB-04 claims form and mailed to HPSM.
Electronic Claims Submission
Using standard EDI 837 format
- Set up your user ID and password by calling Provider Services at 650-616-2106
- FTP (File Transfer Protocol) to www.hpsm.org using dial-in number 650-616-8062
- Plaintext only, migrating to 128-bit SSL encryption
- Change Healthcare (formerly Emdeon and Capario)
- For 837 Professional: SX174
- For 837 Institutional: 12X74
- Office Ally: HPSM1
- Capario: HPSM1
Only CMS-1500 claims can be submitted through our Provider Portal at this time.
Claims Submission Instructions
- General Tips for Billing
- Submitting Claims and Encounter Data
- Required Data Items for CMS-1500
- Required Data Items for UB-04
- Explanation Codes for Claims Payment
For more information contact the Claims Department at 650-616-2106 or ClaimsInquiries@hpsm.org (email confirmation delivered by next business day).