Grievance and Appeals Process

The federal Centers for Medicare and Medicaid Services (CMS) and the State of California have regulations that give health care consumers the right to file complaints about the care and/or service they receive. HPSM and our providers are legally required to comply with these regulations. Here is a summary of your responsibilities regarding HPSM requests for information related to member complaints.

• What is a complaint?
• Providers’ responsibilities
• Response timeframes
• Contact HPSM's G&A Unit

Learn more about HPSM's Grievance and Appeals process in section 3 of HPSM's Provider Manual. 

Grievance and Appeals Unit

Toll free: 1-888-576-7227
Local: 650-616-2850
Fax 650-829-2002

Monday–Friday 8:00 a.m. to 5:00 p.m.