Member Handbooks | HPSM Providers

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collapsed" data-toggle="collapse" data-parent=".accordian-menu"></i> </span> <div class="list-group panel" id="sideNav"> <a href="https://www.hpsm.org/provider/authorizations" class="list-group-item dropdown-item collapsed "> Prior Authorizations <i href="#group-198d53406-40bd-40aa-87e0-0db3f5347735" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-198d53406-40bd-40aa-87e0-0db3f5347735"> <a href="https://www.hpsm.org/provider/authorizations/submitting-prior-authorization-requests" class="list-group-item strong "> Submitting Prior Authorization Requests </a> <a href="https://www.hpsm.org/provider/authorizations/referrals" class="list-group-item strong "> Referrals </a> <a href="https://www.hpsm.org/provider/authorizations/prescription-drugs" class="list-group-item dropdown-item collapsed "> Prescription Authorization Requests <i href="#group-218ae6b77-5995-4a37-bfd5-197d629766b3" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-298d53406-40bd-40aa-87e0-0db3f5347735"></i> </a> <div class="collapse" id="group-218ae6b77-5995-4a37-bfd5-197d629766b3"> <a href="https://www.hpsm.org/provider/authorizations/prescription-drugs/medi-cal-rx-transition-provider-guide" class="list-group-item strong "> Medi-Cal Rx Transition: Provider Guide </a> </div> <a href="https://www.hpsm.org/provider/authorizations/specialty-provider" class="list-group-item strong "> Specialty Provider Authorizations </a> <a href="https://www.hpsm.org/provider/authorizations/par-list-changes" class="list-group-item strong "> PAR List Changes </a> <a href="https://www.hpsm.org/provider/authorizations/glucose-monitors" class="list-group-item strong "> Glucose Monitors </a> </div> <a href="https://www.hpsm.org/provider/claims" class="list-group-item dropdown-item collapsed "> Claims <i href="#group-18eb62825-f4c4-4657-9dd0-f1fcacb37450" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-18eb62825-f4c4-4657-9dd0-f1fcacb37450"> <a href="https://www.hpsm.org/provider/claims/submit-claims" class="list-group-item strong "> Submit Claims </a> <a href="https://www.hpsm.org/provider/claims/update-claims" class="list-group-item strong "> Rebill, Correct or Update Claims </a> <a href="https://www.hpsm.org/provider/claims/disputes-and-appeals" class="list-group-item strong "> Submit a Claims Dispute or Appeal </a> <a href="https://www.hpsm.org/provider/claims/get-paid-faster-with-eft-era" class="list-group-item strong "> Get Paid Faster with EFT/ERA </a> <a href="https://www.hpsm.org/provider/claims/contact-claims" class="list-group-item strong "> Contact Claims Services </a> </div> <a href="https://www.hpsm.org/provider/resources" class="list-group-item dropdown-item collapsed "> Provider Resources <i href="#group-149fc1852-db3d-4a9d-b8ef-a398dd5edc32" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-149fc1852-db3d-4a9d-b8ef-a398dd5edc32"> <a href="https://www.hpsm.org/provider/resources/manual" class="list-group-item dropdown-item collapsed "> Provider Manual <i href="#group-236bd343d-c19b-4f7a-843c-6dfacd5ce75b" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-236bd343d-c19b-4f7a-843c-6dfacd5ce75b"> <a href="https://www.hpsm.org/provider/resources/manual/section-1-about-the-provider-manual" class="list-group-item strong "> Section 1: About HPSM </a> <a href="https://www.hpsm.org/provider/resources/manual/customer-support" class="list-group-item strong "> Section 2: Customer Support </a> <a href="https://www.hpsm.org/provider/resources/manual/member-complaints" class="list-group-item strong "> Section 3: Member Complaints </a> <a href="https://www.hpsm.org/provider/resources/manual/claims" class="list-group-item strong "> Section 4: Claims </a> <a href="https://www.hpsm.org/provider/resources/manual/provider-disputes" class="list-group-item strong "> Section 5: Provider Disputes </a> <a href="https://www.hpsm.org/provider/resources/manual/ancillary-services" class="list-group-item strong "> Section 6: Ancillary Services </a> <a href="https://www.hpsm.org/provider/resources/manual/utilization-management" class="list-group-item strong "> Section 7: Utilization Management </a> <a href="https://www.hpsm.org/provider/resources/manual/provider-services" class="list-group-item strong "> Section 8: Provider Services </a> <a href="https://www.hpsm.org/provider/resources/manual/quality-improvement" class="list-group-item strong "> Section 9: Quality Improvement </a> <a href="https://www.hpsm.org/provider/resources/manual/health-education" class="list-group-item strong "> Section 10: Health Education </a> <a href="https://www.hpsm.org/provider/resources/manual/fraud-waste-and-abuse" class="list-group-item strong "> Section 11: Fraud Waste and Abuse </a> <a href="https://www.hpsm.org/provider/resources/manual/privacy" class="list-group-item strong "> Section 12: Privacy </a> </div> <a href="https://www.hpsm.org/provider/resources/guidelines" class="list-group-item dropdown-item collapsed "> Clinical Guidelines <i href="#group-2f8df306c-1d26-42a0-b5fd-331e9d7d1505" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2f8df306c-1d26-42a0-b5fd-331e9d7d1505"> <a href="https://www.hpsm.org/provider/resources/guidelines/prescribing-controlled-substances" class="list-group-item strong "> Prescribing Controlled Substances </a> <a href="https://www.hpsm.org/provider/resources/guidelines/improving-medication-adherence-for-better-outcomes" class="list-group-item strong "> Improving Medication Adherence for Better Outcomes </a> </div> <a href="https://www.hpsm.org/provider/resources/cultural-competency" class="list-group-item dropdown-item collapsed "> Cultural Competency <i href="#group-2c6b1f100-2700-48b1-bddd-d5cf02a47050" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2c6b1f100-2700-48b1-bddd-d5cf02a47050"> <a href="https://www.hpsm.org/provider/resources/cultural-competency/tips-for-supporting-lgbtqia-patients" class="list-group-item strong "> Supporting LGBTQIA+ Patients </a> <a href="https://www.hpsm.org/provider/resources/cultural-competency/health-literacy" class="list-group-item strong "> Health Literacy </a> </div> <a href="https://www.hpsm.org/provider/resources/language-services" class="list-group-item dropdown-item collapsed "> Language Assistance Services <i href="#group-2684af506-f6ea-4ab4-ac8e-967ef8805735" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2684af506-f6ea-4ab4-ac8e-967ef8805735"> <a href="https://www.hpsm.org/provider/resources/language-services/language-interpreter-services" class="list-group-item dropdown-item collapsed "> Language Interpreter Services <i href="#group-3971724d0-311f-4ba6-9813-d90f0059cfbf" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-3684af506-f6ea-4ab4-ac8e-967ef8805735"></i> </a> <div class="collapse" id="group-3971724d0-311f-4ba6-9813-d90f0059cfbf"> <a href="https://www.hpsm.org/provider/resources/language-services/language-interpreter-services/interpreter-services-request" class="list-group-item strong "> In-person Interpreter Services Request Form </a> <a href="https://www.hpsm.org/provider/resources/language-services/language-interpreter-services/get-a-no-cost-ipad" class="list-group-item dropdown-item collapsed "> Get a No-cost iPad <i href="#group-4fff0c431-0258-4f9b-b607-27837bdf4345" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-4971724d0-311f-4ba6-9813-d90f0059cfbf"></i> </a> <div class="collapse" id="group-4fff0c431-0258-4f9b-b607-27837bdf4345"> </div> </div> <a href="https://www.hpsm.org/provider/resources/language-services/get-translated-member-materials" class="list-group-item strong "> Translated & Alternative Format Member Materials </a> <a href="https://www.hpsm.org/provider/resources/language-services/language-documentation-requirements" class="list-group-item strong "> Language Documentation Requirements </a> <a href="https://www.hpsm.org/provider/resources/language-services/language-training-resources" class="list-group-item dropdown-item collapsed "> Language Training and Resources <i href="#group-3fa95ebc1-f27a-4415-bc3c-0765efa59935" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-3684af506-f6ea-4ab4-ac8e-967ef8805735"></i> </a> <div class="collapse" id="group-3fa95ebc1-f27a-4415-bc3c-0765efa59935"> <a href="https://www.hpsm.org/provider/resources/language-services/language-training-resources/provider-language-assistance-checklist" class="list-group-item strong "> Provider Language Assistance Checklist </a> </div> </div> <a href="https://www.hpsm.org/provider/resources/forms" class="list-group-item dropdown-item collapsed "> Provider Forms <i href="#group-2cc4a9fcf-89a8-400d-8861-036fff50a4a7" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2cc4a9fcf-89a8-400d-8861-036fff50a4a7"> <a href="https://www.hpsm.org/update-my-information" class="list-group-item strong "> Update My Information </a> </div> <a href="https://www.hpsm.org/provider/directory-search" class="list-group-item strong "> Directory Search </a> <a href="https://www.hpsm.org/provider/formulary-search" class="list-group-item strong "> Formulary Search </a> <a href="https://www.hpsm.org/provider/resources/diabetes-prevention-program" class="list-group-item dropdown-item collapsed "> Diabetes Prevention Program <i href="#group-256465877-c942-4d46-ac8e-5ddd06ccea2c" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-256465877-c942-4d46-ac8e-5ddd06ccea2c"> <a href="https://www.hpsm.org/provider/resources/diabetes-prevention-program/dpp-patient-referral-form" class="list-group-item dropdown-item collapsed "> DPP Patient Referral Form <i href="#group-3b18da6c1-e767-4d9e-99b5-b36b6fb866fa" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-356465877-c942-4d46-ac8e-5ddd06ccea2c"></i> </a> <div class="collapse" id="group-3b18da6c1-e767-4d9e-99b5-b36b6fb866fa"> </div> <a href="https://www.hpsm.org/provider/resources/diabetes-prevention-program/smmc-diabetes-program" class="list-group-item strong "> SMMC Diabetes Program </a> </div> <a href="https://www.hpsm.org/provider/resources/end-of-life-care" class="list-group-item strong "> End of Life Care </a> <a href="https://www.hpsm.org/provider/resources/grievance-appeals-process" class="list-group-item dropdown-item collapsed "> Grievance & Appeals Process <i href="#group-2b3455ac9-2dbe-49d9-8122-e8aa4896b81a" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2b3455ac9-2dbe-49d9-8122-e8aa4896b81a"> <a href="https://www.hpsm.org/provider/resources/grievance-appeals-process/what-is-a-complaint" class="list-group-item strong "> What is a complaint? </a> <a href="https://www.hpsm.org/provider/resources/grievance-appeals-process/providers-responsibilities" class="list-group-item strong "> Providers’ responsibilities </a> <a href="https://www.hpsm.org/provider/resources/grievance-appeals-process/response-timeframes" class="list-group-item strong "> Response timeframes </a> <a href="https://www.hpsm.org/provider/resources/grievance-appeals-process/contact-g-a-unit" class="list-group-item strong "> Contact HPSM's G&A Unit </a> </div> <a href="https://www.hpsm.org/provider/resources/healthcare-effectiveness-data-and-information-set" class="list-group-item strong "> Healthcare Effectiveness Data and Information Set </a> <a href="https://www.hpsm.org/provider/resources/home-health-care" class="list-group-item strong "> Home Health Care </a> <a href="https://www.hpsm.org/provider/resources/initial-health-assessment" class="list-group-item dropdown-item collapsed "> Initial Health Appointment <i href="#group-26a1fa7ee-3bb9-43c0-9906-a87e96f3a1a2" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-26a1fa7ee-3bb9-43c0-9906-a87e96f3a1a2"> <a href="https://www.hpsm.org/provider/resources/initial-health-assessment/2023-iha-changes" class="list-group-item strong "> 2023 IHA Changes </a> </div> <a href="https://www.hpsm.org/provider/resources/maternal-health" class="list-group-item strong "> Maternal Care </a> <a href="https://www.hpsm.org/provider/resources/medical-record-and-facility-site-reviews" class="list-group-item strong "> Medical Record and Facility Site Reviews </a> <a href="https://www.hpsm.org/provider/resources/member-handbooks" class="list-group-item strong active"> Member Handbooks </a> <a href="https://www.hpsm.org/provider/resources/healthmatters-md" class="list-group-item dropdown-item collapsed "> HEALTHmatters MD <i href="#group-2d14f87bd-a03d-43fe-a11c-bb7bbda4fbb3" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2d14f87bd-a03d-43fe-a11c-bb7bbda4fbb3"> <a href="https://www.hpsm.org/provider/resources/healthmatters-md/newsletters" class="list-group-item strong "> Newsletter Archive </a> <a href="https://www.hpsm.org/provider/resources/healthmatters-md/provider-notices" class="list-group-item strong "> Provider Notices </a> </div> <a href="https://www.hpsm.org/provider/resources/pediatric-care" class="list-group-item strong "> Pediatric Care </a> <a href="https://www.hpsm.org/provider/resources/potential-quality-issues" class="list-group-item strong "> Potential Quality Issues </a> <a href="https://www.hpsm.org/provider/resources/urgent-care" class="list-group-item strong "> Urgent Care </a> <a href="https://www.hpsm.org/provider/resources/tobacco-cessation-resources" class="list-group-item dropdown-item collapsed "> Tobacco Cessation Information and Resources <i href="#group-2a2e64e2f-647c-4816-96ef-61c922e9f031" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-249fc1852-db3d-4a9d-b8ef-a398dd5edc32"></i> </a> <div class="collapse" id="group-2a2e64e2f-647c-4816-96ef-61c922e9f031"> <a href="https://www.hpsm.org/provider/resources/tobacco-cessation-resources/identifying-tobacco-users" class="list-group-item strong "> Identifying Tobacco Users </a> <a href="https://www.hpsm.org/provider/resources/tobacco-cessation-resources/treating-patients-who-use-tobacco" class="list-group-item strong "> Treating Patients Who Use Tobacco </a> <a href="https://www.hpsm.org/provider/resources/tobacco-cessation-resources/vulnerable-populations" class="list-group-item strong "> Vulnerable Populations </a> <a href="https://www.hpsm.org/provider/resources/tobacco-cessation-resources/provider-education-and-trainings" class="list-group-item strong "> Provider Education and Trainings </a> </div> <a href="https://www.hpsm.org/provider/resources/older-adults-and-persons-with-disabilities" class="list-group-item strong "> Older Adults and People with Disabilities </a> <a href="https://www.hpsm.org/provider/videos" class="list-group-item strong "> Provider Videos </a> <a href="https://www.hpsm.org/provider/resources/remote-patient-monitoring" class="list-group-item strong "> Remote Patient Monitoring </a> </div> <a href="https://www.hpsm.org/provider/care-coordination" class="list-group-item strong "> Care Coordination </a> <a href="https://www.hpsm.org/provider/behavioral-health" class="list-group-item strong "> Behavioral Health </a> <a href="https://www.hpsm.org/provider/incentive-payments" class="list-group-item dropdown-item collapsed "> Provider Incentive Programs <i href="#group-120d1dcb7-63c0-4f34-80c4-9114c53527ed" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-120d1dcb7-63c0-4f34-80c4-9114c53527ed"> <a href="https://www.hpsm.org/provider/incentive-payments/incentive-payments-for-primary-care-providers" class="list-group-item dropdown-item collapsed "> Incentives for Primary Care Providers <i href="#group-268f151c5-4ff8-46cb-a0d0-b9162ad1b71a" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-220d1dcb7-63c0-4f34-80c4-9114c53527ed"></i> </a> <div class="collapse" id="group-268f151c5-4ff8-46cb-a0d0-b9162ad1b71a"> <a href="https://www.hpsm.org/provider/incentive-payments/incentive-payments-for-primary-care-providers/care-gap-p4p-incentive-program-interest-form" class="list-group-item strong "> Care Gap P4P Incentive Program Interest Form </a> </div> <a href="https://www.hpsm.org/provider/incentive-payments/incentive-payments-for-nursing-facilities" class="list-group-item strong "> Incentives for Nursing Facilities </a> <a href="https://www.hpsm.org/provider/incentive-payments/incentive-payments-for-specialists" class="list-group-item strong "> Incentives for Specialty Providers  </a> </div> <a href="https://www.hpsm.org/provider/learning-lab" class="list-group-item strong "> Learning Lab </a> <a href="https://www.hpsm.org/provider/sb855-training-request" class="list-group-item strong "> SB855 Training Request </a> <a href="https://www.hpsm.org/provider/hpsm-dental" class="list-group-item dropdown-item collapsed "> HPSM Dental Providers <i href="#group-174f36575-3241-48b1-9e76-4b1c1d28f8cf" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-174f36575-3241-48b1-9e76-4b1c1d28f8cf"> <a href="https://www.hpsm.org/provider/hpsm-dental/join-hpsm-dental" class="list-group-item dropdown-item collapsed "> Join HPSM Dental <i href="#group-2388b7643-c933-4415-be9e-c964394a836a" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-274f36575-3241-48b1-9e76-4b1c1d28f8cf"></i> </a> <div class="collapse" id="group-2388b7643-c933-4415-be9e-c964394a836a"> </div> <a href="https://www.hpsm.org/provider/hpsm-dental/payments" class="list-group-item strong "> Dental Provider Payments </a> <a href="https://www.hpsm.org/provider/hpsm-dental/covered-dental-services" class="list-group-item strong "> Covered Dental Services </a> <a href="https://www.hpsm.org/provider/hpsm-dental/benefits-of-dental-integration" class="list-group-item strong "> Benefits of Dental Integration </a> <a href="https://www.hpsm.org/provider/hpsm-dental/mission" class="list-group-item strong "> HPSM Dental Mission </a> <a href="https://www.hpsm.org/provider/hpsm-dental/an-innovative-pilot-program" class="list-group-item strong "> An Innovative Pilot Program </a> </div> <a href="https://www.hpsm.org/provider/patient-experience" class="list-group-item dropdown-item collapsed "> Patient Experience <i href="#group-14796c813-89d5-457a-b717-557ed7328da7" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-14796c813-89d5-457a-b717-557ed7328da7"> <a href="https://www.hpsm.org/provider/patient-experience/cahps-survey" class="list-group-item strong "> CAHPS Survey </a> </div> <a href="https://www.hpsm.org/provider/calaim-at-hpsm" class="list-group-item dropdown-item collapsed "> CalAIM at HPSM <i href="#group-167f12e56-7522-48b7-aaa7-68b7a007b163" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-167f12e56-7522-48b7-aaa7-68b7a007b163"> <a href="https://www.hpsm.org/provider/calaim-at-hpsm/enhanced-care-management-(ecm)" class="list-group-item strong "> Enhanced Care Management (ECM) </a> <a href="https://www.hpsm.org/provider/calaim-at-hpsm/community-supports-(cs)" class="list-group-item strong "> Community Supports (CS) </a> </div> <a href="https://www.hpsm.org/provider/urgent-messages" class="list-group-item dropdown-item collapsed "> Urgent Messages <i href="#group-15bc380af-3a0c-4750-aba7-b97106a561bd" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-15bc380af-3a0c-4750-aba7-b97106a561bd"> <a href="https://www.hpsm.org/provider/urgent-messages/provider-covid-19-resources" class="list-group-item strong "> Provider COVID-19 Resources </a> <a href="https://www.hpsm.org/provider/urgent-messages/monkeypox" class="list-group-item dropdown-item collapsed "> Mpox (Monkeypox) <i href="#group-2bf4fc89c-c2e8-4a7b-8c2e-fa99faed8e19" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-25bc380af-3a0c-4750-aba7-b97106a561bd"></i> </a> <div class="collapse" id="group-2bf4fc89c-c2e8-4a7b-8c2e-fa99faed8e19"> </div> <a href="https://www.hpsm.org/provider/urgent-messages/prepare-for-power-shutoffs" class="list-group-item strong "> Prepare for Power Shutoffs </a> </div> <a href="https://www.hpsm.org/provider/news" class="list-group-item strong "> News & Updates </a> <a href="https://www.hpsm.org/provider/portal" class="list-group-item strong "> Provider Portal / eReports </a> <a href="https://www.hpsm.org/provider/join-the-network" class="list-group-item strong "> Join Our Provider Network </a> <a href="https://www.hpsm.org/provider/contact-provider-services" class="list-group-item dropdown-item collapsed "> Provider Contacts <i href="#group-1e0265f57-f2de-4917-b33c-849c70bc8164" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-135bd4b25-8293-494c-84ae-6452bf4545bb"></i> </a> <div class="collapse" id="group-1e0265f57-f2de-4917-b33c-849c70bc8164"> <a href="https://www.hpsm.org/provider/contact/nomination-form" class="list-group-item strong "> Nominate a Colleague </a> </div> <a href="https://www.hpsm.org/provider/all-tasks" class="list-group-item strong "> All Provider Tasks </a> </div> </div> </div> <div class="related-items">  <div class="card"> <h3> </h3> <div class="name-and-phone-list"> <h5> </h5> </div> <div class="name-and-phone-list"> <h5> </h5> </div> <div class="name-and-phone-list"> <h5> </h5> </div> </div> </div> </div> <div class="col-xs-12 col-sm-8 col-sm-pull-4"> <div class="content-area container-fluid-margin"> <div class="sf_cols" data-sf-element="Row"> <div class="sf_colsOut sf_1col_1_100"> <div id="Contentplaceholder_TACCE306D001_Col00" class="sf_colsIn sf_1col_1in_100" data-sf-element="Column 1"> <div > <div class="sfContentBlock sf-Long-text" ><h1>Member Manuals<br></h1></div> </div> </div> </div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h3 id="eoc-tabs">Member Handbooks / Evidence of Coverage</h3><p>The Member Handbook / Evidence of Coverage tells members about the covered benefits for their plan. It also explains their rights and responsibilities as a member of HPSM.</p><div class="color-tabs notranslate"><ul class="nav nav-tabs responsive-tabs"><li class="active lang-en"><a href="#panelenmh" tabindex="1" data-sf-ec-immutable="">English</a></li><li class="lang-es"><a href="#panelesmh" tabindex="2" data-sf-ec-immutable="">Español</a></li><li class="lang-zh"><a href="#panelzhmh" tabindex="3" data-sf-ec-immutable="">中文</a></li><li class="lang-fil"><a href="#panelfilmh" tabindex="4" data-sf-ec-immutable="">Tagalog</a></li></ul><div class="tab-content"><div class="tab-pane active" id="panelenmh"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_eoc2025_m_en.pdf?sfvrsn=ab811568_12" title="CareAdvantage 2025 Member Handbook" class="download" target="_blank">CareAdvantage D-SNP 2025 Member Handbook</a> <a href="/docs/default-source/member-manuals/healthworx_evidence_of_coverage_english.pdf?sfvrsn=eed9c80a_91" title="HealthWorx HMO Evidence of Coverage " class="download" target="_blank">HealthWorx HMO Evidence of Coverage </a> <a href="/docs/default-source/member-manuals/medi-cal-member-handbook-english.pdf?sfvrsn=fa21ef70_66" title="Medi-Cal Member Handbook / Evidence of Coverage " class="download" target="_blank">Medi-Cal Member Handbook / Evidence of Coverage </a> <a href="/docs/default-source/member-manuals/ace_handbook_english.pdf?sfvrsn=c5a6eb1a_25" title="San Mateo County ACE Participant Handbook" class="download" target="_blank">San Mateo County ACE Participant Handbook</a> </div><div class="tab-pane" id="panelesmh"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_eoc2025_m_sp.pdf?sfvrsn=ab811568_12" title="CareAdvantage 2025 Manual para los Miembro" class="download" target="_blank" data-sf-ec-immutable="">CareAdvantage D-SNP 2025 Manual para los Miembro</a> <a href="/docs/default-source/member-manuals/healthworx_evidence_of_coverage_spanish.pdf?sfvrsn=eed9c80a_79" title="HealthWorx HMO Evidencia de Cobertura" class="download" target="_blank" data-sf-ec-immutable="">HealthWorx HMO Evidencia de Cobertura</a> <a href="/docs/default-source/member-manuals/medi-cal-member-handbook-spanish.pdf?sfvrsn=fa21ef70_58" title="Manual del Miembro de Medi-Cal " class="download" target="_blank" data-sf-ec-immutable="">Manual del Miembro de Medi-Cal</a> <a href="/docs/default-source/member-manuals/ace_handbook_spanish.pdf" title="San Mateo County ACE Manual del Participante" class="download" data-sf-ec-immutable="">San Mateo County ACE Manual del Participante</a> </div><div class="tab-pane" id="panelzhmh"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_eoc2025_m_ch.pdf?sfvrsn=ab811568_12" title="CareAdvantage 會員手冊 (快來了)" class="download" target="_blank" data-sf-ec-immutable="">CareAdvantage D-SNP 2025 會員手冊 (快來了)</a> <a href="/docs/default-source/member-manuals/healthworx_evidence_of_coverage_chinese.pdf?sfvrsn=eed9c80a_79" title="HealthWorx HMO 會員手冊及承保說明書" class="download" target="_blank" data-sf-ec-immutable="">HealthWorx HMO 會員手冊及承保說明書</a> <a href="/docs/default-source/member-manuals/medi-cal-member-handbook-chinese.pdf?sfvrsn=fa21ef70_58" title="Medi-Cal 會員手冊及承保說明書" class="download" target="_blank" data-sf-ec-immutable="">Medi-Cal 會員手冊及承保說明書 </a> </div><div class="tab-pane" id="panelfilmh"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_eoc2025_m_ta.pdf?sfvrsn=ab811568_12" title="CareAdvantage Aklat-Gabay ng Miyembro" class="download" target="_blank" data-sf-ec-immutable="">CareAdvantage D-SNP 2025 Aklat-Gabay ng Miyembro</a> <a href="/docs/default-source/member-manuals/healthworx_evidence_of_coverage_tagalog.pdf?sfvrsn=eed9c80a_79" title="HealthWorx HMO Aklat-Gabay ng Miyembro at Katibayan ng Pagkakasakop" class="download" target="_blank" data-sf-ec-immutable="">HealthWorx HMO Aklat-Gabay ng Miyembro at Katibayan ng Pagkakasakop</a> <a class="download" href="/docs/default-source/member-manuals/medi-cal-member-handbook-tagalog.pdf?sfvrsn=fa21ef70_58" target="_blank" title="Medi-Cal Aklat-Gabay ng Miyembro at Katibayan ng Pagkakasakop" data-sf-ec-immutable="">Medi-Cal Aklat-Gabay ng Miyembro at Katibayan ng Pagkakasakop</a> </div></div></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h3 id="sob-tabs">Summary of Benefits</h3><p>The Summary of Benefits is a brief overview of the benefits and services covered by the plan. </p><div class="color-tabs notranslate"><ul class="nav nav-tabs responsive-tabs"><li class="active lang-en"><a href="#panelen2" tabindex="1" data-sf-ec-immutable="">English</a></li><li class="lang-es"><a href="#paneles2" tabindex="2" data-sf-ec-immutable="">Español</a></li><li class="lang-zh"><a href="#panelzh2" tabindex="3" data-sf-ec-immutable="">中文</a></li><li class="lang-fil"><a href="#panelfil2" tabindex="4" data-sf-ec-immutable="">Tagalog</a></li></ul><div class="tab-content"><div class="tab-pane active" id="panelen2"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_sob2025_m-en.pdf?sfvrsn=b68bec3a_22" title="CareAdvantage 2025 Summary of Benefits" class="download" target="_blank">CareAdvantage D-SNP 2025 Summary of Benefits</a> <a href="/docs/default-source/member-manuals/healthworx_summary_of_benefits_english.pdf?sfvrsn=87b251d2_30" title="HealthWorx HMO Summary of Benefits " class="download" target="_blank">HealthWorx HMO Summary of Benefits</a> </div><div class="tab-pane" id="paneles2"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_sob2025_m-sp.pdf?sfvrsn=b68bec3a_22" title="CareAdvantage Resumen de Beneficios" class="download" target="_blank">CareAdvantage D-SNP 2025 Resumen de Beneficios</a> <a href="/docs/default-source/member-manuals/healthworx_summary_of_benefits_spanish.pdf?sfvrsn=87b251d2_30" title="HealthWorx HMO Resumen de Beneficios" class="download" target="_blank">HealthWorx HMO Resumen de Beneficios</a> </div><div class="tab-pane" id="panelzh2"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_sob2025_m-ch.pdf?sfvrsn=b68bec3a_22" title="CareAdvantage 福利摘要" class="download" target="_blank">CareAdvantage D-SNP 2025 福利摘要</a> <a href="/docs/default-source/member-manuals/healthworx_summary_of_benefits_chinese.pdf?sfvrsn=87b251d2_30" title="HealthWorx HMO 福利及承保摘要" class="download" target="_blank">HealthWorx HMO 福利及承保摘要</a> </div><div class="tab-pane" id="panelfil2"><a href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_sob2025_m-ta.pdf?sfvrsn=b68bec3a_22" title="CareAdvantage Buod ng Mga Benepisyo" class="download" target="_blank">CareAdvantage D-SNP 2025 Buod ng Mga Benepisyo</a> <a href="/docs/default-source/member-manuals/healthworx_summary_of_benefits_tagalog.pdf?sfvrsn=87b251d2_30" title="HealthWorx HMO Buod ng Mga Benepisyo" class="download" target="_blank">HealthWorx HMO Buod ng Mga Benepisyo</a> </div></div></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h3 id="formulary-tabs">Formulary</h3><p>The Formulary is a list of medicines that are covered under each HPSM plan's preferred medicine list. If a provider wants to prescribe an HPSM member a medicine that is not on this list, the provider must get prior authorization from before prescribing the medicine.</p><div class="color-tabs notranslate"><ul class="nav nav-tabs responsive-tabs"><li class="active lang-en"><a href="#panelenformulary" tabindex="1">English</a></li><li class="lang-es"><a href="#panelesformulary" tabindex="2">Español</a></li><li class="lang-zh"><a href="#panelzhformulary" tabindex="3">中文</a></li><li class="lang-fil"><a href="#panelfilformulary" tabindex="4">Tagalog</a></li></ul><div class="tab-content"><div class="tab-pane active" id="panelenformulary"><a class="external" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=cf896448-bca8-4a90-9446-bd037eb6129a" target="_blank" title="CareAdvantage 2025 Formulary">CareAdvantage D-SNP 2025 Formulary</a> <a class="download" href="https://medi-calrx.dhcs.ca.gov/home" target="_blank" title="Medi-Cal Formulary">Medi-Cal Formulary</a> <a class="download" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=e2b9faaa-1d6f-4a2d-bf06-e870ab2940fc" target="_blank" title="HealthWorx Formulary">HealthWorx Formulary</a> <a class="download" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web?planid=5580029e-1ea2-4180-b6cf-882d985a8b40" target="_blank" title="San Mateo County ACE Formulary">San Mateo County ACE Formulary</a> </div><div class="tab-pane" id="panelesformulary"><a class="external" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=cf896448-bca8-4a90-9446-bd037eb6129a" target="_blank" title="CareAdvantage 2025 Formulary">CareAdvantage D-SNP 2025 Lista de medicamentos cubiertos</a><a class="download" href="https://medi-calrx.dhcs.ca.gov/home" target="_blank" title="Medi-Cal Lista de medicamentos cubiertos">Medi-Cal Lista de medicamentos cubiertos</a> <a class="download" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=e2b9faaa-1d6f-4a2d-bf06-e870ab2940fc" target="_blank" title="HealthWorx Formulary">HealthWorx Lista de medicamentos cubiertos</a> <a class="download" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web?planid=5580029e-1ea2-4180-b6cf-882d985a8b40" target="_blank" title="San Mateo County ACE Lista de medicamentos cubiertos">San Mateo County ACE Lista de medicamentos cubiertos</a> </div><div class="tab-pane" id="panelzhformulary"><a class="external" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=cf896448-bca8-4a90-9446-bd037eb6129a" target="_blank" title="CareAdvantage 2025 Formulary">CareAdvantage D-SNP 2025 承保藥物清單</a><a class="download" href="https://medi-calrx.dhcs.ca.gov/home" target="_blank" title="Medi-Cal 承保藥物清單">Medi-Cal 承保藥物清單</a> <a class="download" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=e2b9faaa-1d6f-4a2d-bf06-e870ab2940fc" target="_blank" title="HealthWorx Formulary">HealthWorx 承保藥物清單</a> </div><div class="tab-pane" id="panelfilformulary"><a class="external" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=cf896448-bca8-4a90-9446-bd037eb6129a" target="_blank" title="CareAdvantage 2025 Formulary">CareAdvantage D-SNP 2025 Listahan ng Mga Sakop na Gamot</a><a class="download" href="https://medi-calrx.dhcs.ca.gov/home" target="_blank" title="Medi-Cal Formulary">Medi-Cal Listahan ng Mga Sakop na Gamot</a> <a class="download" href="https://rx1-ext.rxtransaction.com/savantrx-drugsearch-url-web/?planid=e2b9faaa-1d6f-4a2d-bf06-e870ab2940fc" target="_blank" title="HealthWorx Formulary">HealthWorx Listahan ng Mga Sakop na Gamot</a> </div></div></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h3 id="directory-tabs">Provider Directory</h3><p>The Provider Directory lists hospitals, clinics, pharmacies, PCPs, specialists, medical equipment providers and others that participate in the HPSM network. The Directory includes providers' names, addresses, phone numbers, business hours, languages spoken and more. </p><div class="page-documents"><div class="color-tabs notranslate"><div class="responsive-tabs-container accordion-xs accordion-sm"><ul style="list-style-type: none; padding-left: 0" class="nav nav-tabs responsive-tabs"><li class="lang-en active"><a href="#panelenpd" tabindex="1">English</a> </li><li class="lang-es "><a href="#panelespd" tabindex="2">Español</a> </li><li class="lang-zh "><a href="#panelzhpd" tabindex="3">中文</a> </li><li class="lang-fil "><a href="#panelfilpd" tabindex="4">Tagalog</a> </li></ul><div class="tab-content"><a href="#panelenpd" tabindex="1" class="accordion-link active first">English</a><div class="tab-pane active first" id="panelenpd"><a href="https://www.hpsm.org/docs/default-source/member-manuals/hpsm_directory_ca-dsnp-2025_202411110909.pdf?sfvrsn=92538546_14" target="_blank" class="download" tabindex="1">CareAdvantage D-SNP 2025 Provider Directory <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal_provider_directory.pdf?sfvrsn=86cc3c4f_540" target="_blank" class="download" tabindex="1">Medi-Cal Provider Directory <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/healthworx_provider_directory.pdf?sfvrsn=188e1029_527" target="_blank" class="download" tabindex="1">HealthWorx HMO Provider Directory <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/ace_provider_directory.pdf?sfvrsn=14f41365_43" target="_blank" class="download" tabindex="1">San Mateo County ACE Provider List <span></span></a> </div><a href="#panelespd" tabindex="2" class="accordion-link">Español</a><div class="tab-pane " id="panelespd"><a href="https://www.hpsm.org/docs/default-source/member-manuals/hpsm_directory_ca-dsnp-2025_202411110909.pdf?sfvrsn=92538546_14" target="_blank" class="download" tabindex="2">CareAdvantage D-SNP 2025 Directorio de proveedores y farmacias <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal_provider_directory.pdf?sfvrsn=86cc3c4f_540" target="_blank" class="download" tabindex="2">Medi-Cal directorio de proveedores y farmacias <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/healthworx_provider_directory.pdf?sfvrsn=188e1029_527" target="_blank" class="download" tabindex="2">HealthWorx HMO Directorio de proveedores y farmacias <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/ace-provider-directory-sp.pdf?sfvrsn=14f41365_43" target="_blank" class="download" tabindex="2">San Mateo County ACE Lista de Proveedores <span></span></a> </div><a href="#panelzhpd" tabindex="3" class="accordion-link">中文</a><div class="tab-pane " id="panelzhpd"><a href="https://www.hpsm.org/docs/default-source/member-manuals/hpsm_directory_ca-dsnp-2025_202411110909.pdf?sfvrsn=92538546_14" target="_blank" class="download" tabindex="3">CareAdvantage D-SNP 2025 服務提供者及藥房名錄 <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal_provider_directory.pdf?sfvrsn=86cc3c4f_540" target="_blank" class="download" tabindex="3">Medi-Cal 服務提供者及藥房名錄 <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/healthworx_provider_directory.pdf?sfvrsn=188e1029_527" target="_blank" class="download" tabindex="3">HealthWorx HMO 服務提供者及藥房名錄 <span></span></a> </div><a href="#panelfilpd" tabindex="4" class="accordion-link last">Tagalog</a><div class="tab-pane " id="panelfilpd"><a href="https://www.hpsm.org/docs/default-source/member-manuals/hpsm_directory_ca-dsnp-2025_202411110909.pdf?sfvrsn=92538546_14" target="_blank" class="download" tabindex="4">CareAdvantage D-SNP 2025 Direktoryo ng Tagabigay ng Serbisyo at Parmasiya <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal_provider_directory.pdf?sfvrsn=86cc3c4f_540" target="_blank" class="download" tabindex="4">Medi-Cal Direktoryo ng Tagabigay ng Serbisyo at Parmasiya <span></span></a> <a href="https://www.hpsm.org/docs/default-source/member-manuals/healthworx_provider_directory.pdf?sfvrsn=188e1029_527" target="_blank" class="download" tabindex="4">HealthWorx HMO Direktoryo ng Tagabigay ng Serbisyo at Parmasiya <span></span></a> </div></div></div></div> </div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> </div> <div class="container-fluid-margin"> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> </div> </div> </div> </div>  <div class="pre-footer reveal-fade-in"> <div class="container-fluid"> <div class="row"> <div class="col-sm-12"> </div> </div> </div> </div> </main> <footer> <div class="row pb-3"> <div class="col-xs-12 col-sm-3 col-md-3"> <div> <img style="width:150px;" role="presentation" src="/assets/_img/hpsm-logo.png" /> <p class="notranslate"><span class="block">801 Gateway Blvd., Suite 100</span><span 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