Provider Manual | Section 10

Health Education

Health Education

At the Health Plan of San Mateo (HPSM) we believe that healthy is for everyone. We offer a variety of resources to help our members learn how to live well and be healthy. Topics include asthma, diabetes, weight management, pregnancy, and smoking cessation.

Physician Authority

No action of notice by Health Plan of San Mateo shall require a participating physician to provide to the Member, or order on behalf of the Member, Covered Services which, in the professional opinion of the physician, are not medically necessary. Participating physicians may freely communicate with Members who are patients about their treatment, regardless of benefit coverage and limitations. When a physician determines that a Member-requested service is not medically necessary, and if the Member does not agree with the PCP’s decision, the Physician shall inform the Member of their appeal rights through Health Plan of San Mateo.


Diabetes Prevention Program

This evidence-based 12-month lifestyle change program for HPSM Medi-Cal and CareAdvantage Dual Eligible Special Needs Plans (D-SNP) members with pre-diabetes is designed to prevent or delay the onset of type 2 diabetes. Members get advice from a trained Lifestyle Coach on how to make healthy lifestyle changes, like eating healthier and being more physically active. They also get educational materials and group support. HPSM provides DPP to eligible members at no cost. To learn more about eligibility requirements and to access the DPP Provider Referral Form, providers can visit HPSM's Diabetes Prevention Program page.

Members can visit HPSM's Diabetes page or can contact our Health Education department at 650-616-2165.


Members recently diagnosed with diabetes or who are having difficulty following diabetes health guidelines can contact our Health Education department at 650-616-2165 for information about classes or other resources available. To get more information about diabetes, members can also go to our diabetes health tips page.

Baby + Me

Our prenatal and postpartum care program has been expanded and rebranded to the Baby+Me program. The program will continue to include our incentive for timely prenatal and postpartum care, we will also provide information on how mothers and their babies can receive more comprehensive care. The program will help connect our members to resources and education around:

  • Maternal mental health.
  • Gestational diabetes.
  • Smoking cessation during pregnancy.
  • Immunizations.
  • Well care visits.

For more information, contact our Health Education department at 650-616-2165.

Physical Activity

HPSM members who are interested in physical activity are referred to San Mateo County Park and Recreation Department programs. For more information, contact our Health Education department at 650-616-2165.

Tobacco Cessation Services

Providers are required annually to identify and track tobacco use for each adolescent and adult member. They are also encouraged to refer members to Kick it California. Kick it California is a program that helps people quit with phone coaching and text reminders. Phone coaching is provided in English, Spanish, Chinese, Korean, and Vietnamese. Learn more at or dial 800-300-8086.

To get more information about quitting tobacco and resources available to help them quit, members can go to our Quit Smoking Health Tips page or can contact our Health Education department at 650-616-2165.

Nicotine Replacement Therapies

HPSM covers all FDA-approved tobacco cessation medications for adults who use tobacco products. Medication treatment options include nicotine replacement and medications that reduce cravings. Providers must provide a prescription for all tobacco cessation products including over-the-counter (OTC) products in order for HPSM or Medi-Cal Rx to cover the cost. HPSM Medi-Cal members can get tobacco cessation products through their pharmacy benefit with Medi-Cal Rx. Other HPSM plans may place coverage limitations on some tobacco cessation products. For more information, visit our Formulary Search Page

Health Education Materials

At HPSM, we place a great emphasis on primary prevention in all our work because we believe preventing a disease is the most effective way to keep a person healthy. Our online Health Tips pages offer a wide variety of health information and tips for staying healthy. Members can access our Health Tips pages.

Topics covered include:

  • Alcohol and Drugs.
  • Alternative Care.
  • Asthma.
  • Child Health.
  • Diabetes.
  • Exercise.
  • Flu.
  • Heart Disease and Stroke.
  • HIV and AIDS.
  • LGBTQ+ Health.
  • Medication Management.
  • Mental Health.
  • Nutrition.
  • Older Adults.
  • Pain Management.
  • Oral Health.
  • People with Disabilities.
  • Pregnancy.
  • Preventive Care.
  • Quitting Tobacco Use.
  • Self-Management Tools.
  • Sexual Health.
  • Teen Health.
  • Weight Management.

For more information contact our Health Education department at 650-616-2165.

Member Newsletter

Health Matters is HPSM’s biannual member newsletter. It includes articles on a variety of topics to help keep our members healthy. To view current and past issues of Health Matters, visit Member Newsletter page.

Culturally and Linguistically Appropriate Services (CLAS)

The Health Plan of San Mateo (HPSM) is committed to delivering culturally and linguistically appropriate services to all eligible members with limited English proficiency (LEP) or sensory impairment. Understanding these requirements will help you provide quality care to our members and meet federal and state requirements.

Provider Responsibility

All HPSM contracted providers are required to provide linguistically appropriate services to members with limited English proficiency (LEP) or with a hearing impairment. HPSM therefore offers free phone, video and (in certain circumstances) in-person interpreter services provided by professionally trained interpreters. Understanding these services will help you meet state and federal regulatory requirements and provide quality care to your patients.

HPSM’s CLAS Program complies with Title IV of the Civil Rights Act of 1964, which states, any agency, program, or activity that receives funding from federal government may not discriminate on the basis of race, color, national origin, creed, ancestry, religion, language, age, marital status, health status, disabilities, gender, sexual orientation, or gender identity.

Learn about our Language Assistance program.

Interpreter Services

HPSM provides free telephonic, video, in-person, and American Sign Language (ASL) interpreter services to help you communicate with your LEP patients.

  • Telephonic interpreter services are provided through Certified Languages International (CLI) and are available in more than 200 languages 24 hours a day, 7 days a week.
  • Video Remote Interpreter (VRI) services are also provided through CLI and are available on demand and by appointment through CLI’s online platform. The service includes ASL video interpreter services.
  • In-person interpreter services are suspended for all languages other than ASL until further notice.
  • In-person ASL interpreter services are available by appointment and should be requested at least 5 days in advance.
  • All in-person ASL interpreter services should be scheduled by the provider through HPSM. Requests forms can be sent by secure email to or faxed to 650-829-2079.

To learn how to access these services, visit Language Assistance Services.

As a reminder, HPSM interpreter services are meant to be used for HPSM members and/or their medical decision makers only. Vendor utilization is monitored and education is provided should HPSM interpreter services appear to be utilized incorrectly.

Telephonic Interpreter Services for Office/Clinic & Telemedicine Visit

To access the service:

  • Dial CLI at 800-225-5254.
  • Provide the CLI operator with the following information:
    • Access code: 64095.
    • Language needed.
    • Provider office name.
    • HPSM member name.
    • HPSM member date of birth (DOB).
  • For an office visit, start conversation after the CLI operator connects you to an interpreter.
  • For telemedicine visit, provide HPSM patient phone number. After you have briefed the interpreter, dial # to call the HPSM patient at the number you provided the CLI operator. Start conversation once you are connected to the HPSM patient.

Video Remote Interpreter Services for Office/Clinic & Telemedicine

Visit Ensure you have Wi-Fi at the office/clinic for online access to CLI platform. For a telemedicine visit, also ensure HPSM member has internet access to receive telemedicine appointment link.

To access the service:

  • Using either Chrome, Firefox, or Safari web browser, go to CLI platform:
  • Access code: 64095hpsm
  • Follow prompts for clinic/provider name, HPSM patient’s full name and date of birth.
  • Select language.
  • Wait for interpreter to appear on the screen.
  • For telemedicine visit, inform interpreter that you will be inviting your patient to the session.
    • Click the button with the outline of a person and a + sign to send meeting link to HPSM patient via text or email. HPSM patient needs to click the link to join the video call.

Instructions and a video tutorial can be found on our Get a Phone or Video Interpreter page.

In-person Interpreter Services

Suspended due to COVID-19 for all languages except ASL. If the request is not for an in-person ASL interpreter, please use our telephonic or video interpreter. All in-person ASL interpreter services should be scheduled through HPSM at least five days in advance.

To schedule an in-person ASL interpreter:

Provider Language Documentation Requirements for Members with Limited English Proficiency

  1. Document the member's language preferences and language services that were offered (other than English).
    1. For members with limited English proficiency, document their preferred language in their medical record.
    2. At every point of care (onsite or virtual) inform members that they have access to phone or video interpreters free of charge and offer to get an interpreter.
    3. Document the date that interpreter services were offered and indicate whether member agreed or declined assistance.
  2. Document your staff's bilingual capabilities and keep HPSM informed of changes. Because HPSM publishes the language capabilities of all network providers in its provider directories, providers must inform Provider Services about:
    1. The availability of practitioners and staff who are fluent in the preferred languages of assigned members, including:
      1. Demonstration of proficiency in preferred languages.
      2. Assessment of language proficiency.
      3. Number of years’ experience working as a qualified medical interpreter (if any).
      4. Changes to staff’s language proficiencies (e.g., if a staff member who speaks a preferred language no longer works for the practice).
    2. You can update your provider directory listing in the provider portal.

Note: Except for an emergency involving an imminent threat to the safety or welfare of the individual or the public, Providers cannot suggest that HPSM members use family members (including children) or friends as informal interpreters. If an HPSM member refuses professional interpreter services and insists on using a family member or friend and the accompanying adult agrees to provide that assistance, the provider must document the member’s preference in their medical record.

Services for Members with Disabilities

HPSM recognizes that our members with disabilities have specific needs in addition to their general medical needs. We provide services that are integrated within the daily activities of every department, such as:

  • Access to TTY for our hard-of-hearing members.
  • Large-print materials for our visually impaired members.
  • Information on the physical accessibility of providers offices in our provider directory for our wheelchair-using members.

We also have a Care Coordination/Integrated Care Management unit in our Health Services Department to assist our members with complex chronic conditions to ensure they receive the care management they need to optimize their health outcomes. If you have HPSM members with disabilities who need additional services, please notify HPSM Care Coordination/Integrated Care Management unit at 650-616-2060.