The Health Plan of San Mateo (HPSM) Provider Portal is a comprehensive online platform designed to streamline administrative tasks and enhance communication for healthcare providers serving San Mateo County’s vulnerable and underinsured residents.
Official Links
- Provider Portal: https://www.hpsm.org/provider/portal
- Provider Resources: https://www.hpsm.org/provider
What Healthcare Providers Can Do
The HPSM Provider Portal offers multiple critical functionalities:
Key Portal Functions
- Verify member eligibility
- Check claims payment status
- Submit prior authorization requests
- Track authorization request status
- Sign up and manage Electronic Funds Transfer (EFT)
- Submit electronic claims online
Access and Login
User Registration
- Existing users: Direct login available
- New users:
- Register online
- Call 650-616-2106 for assistance
Claims Submission Details
HPSM accepts electronic claims through:
- Office Ally (Payer ID: HPSM1)
- Change Healthcare (Payer IDs: SX174, 12X74)
- WayStar (Payer ID: HPSM1)
Claim Submission Channels
- CMS-1500 format claims: Online submission
- UB04 (Institutional) claims: FTP, Office Ally, or Change Healthcare
eReports Features
Providers can access:
- Remittance advices
- Value-Based Payment Program reports
- Personalized patient engagement data
- Primary care panel assignment reports
- Capitation reports
Privacy and Security
The portal emphasizes:
- Secure access
- Confidential information management
- Compliance with healthcare privacy standards
Support and Assistance
Contact Information
- Phone: 650-616-2106
- Email: [email protected]
- Address: 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080
Additional Support Resources
- Video tutorial: Signing Up for HPSM’s Provider Portal
- Provider Contacts page for Medical Director communication
Accessibility
HPSM provides:
- TTY: 1-800-735-2929
- Alternative dial: 7-1-1
- Language assistance services
Unprovided Information
While the sources provide comprehensive portal details, specific information was not available about:
- Exact login page URL
- Detailed step-by-step registration process
- Specific security protocols
- Mobile app availability
The HPSM Provider Portal represents a robust, user-friendly platform enabling healthcare providers to efficiently manage patient-related administrative tasks while maintaining high standards of care and accessibility.
Recommended Next Steps
- Review the provider portal resources
- Contact HPSM support for specific registration guidance
- Explore available tutorial materials
Note: Information current as of August 2025, based on HPSM provider resources.
FAQ
Is the Health Plan of San Mateo the same as Medi-Cal?Is the Health Plan of San Mateo Medi-Cal? Yes, the Health Plan of San Mateo (HPSM) offers Medi-Cal services to eligible residents of San Mateo County. Medi-Cal is California’s version of Medicaid, a public insurance program that provides health coverage to low-income individuals and families.
What is the phone number for San Mateo health Plan provider?Electronic Claims Options
To get set up with a clearinghouse, please contact the Provider Services department at 650-616-2106 or [email protected].
What is the Health Plan of San Mateo Care Advantage Plan?CareAdvantage by Health Plan of San Mateo is a Dual Eligible Special Needs Plan (D-SNP) that combines Medicare and Medi-Cal into one comprehensive, convenient insurance program. It’s specifically designed to meet the unique health needs and life challenges of people 65 and over and those with chronic health conditions.
Who qualifies for the Health Plan of San Mateo?Who is eligible. Medi-Cal covers low-income adults, families with children, seniors, persons with disabilities, pregnant women, children in foster care and former foster youth up to age 26. To check your eligibility or Medi-Cal application status, call the San Mateo County Human Services Agency at 1-800-223-8383.
https://www.hpsm.org/provider/portal
Provider Portal · Existing users login here · New user? Register here or by calling 650-616-2106. Submit claims online. Submit CMS-1500 format claims online
https://www.hpsm.org/provider
Search provider forms, provider portal, search the formulary, search the provider directory, HPSM Dental Providers, Dental Provider Payments.