[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-290025-105":53,"doc-detail-290025-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","health-plan-of-san-mateo-prior-authorization-form-instructions-provider-guide","Health Plan of San Mateo - Prior Authorization Form Instructions - Provider Guide","","This document provides essential instructions for healthcare providers regarding the updated Prior Authorization form for the Health Plan of San Mateo (HPSM). It emphasizes the mandatory transition to the new fillable PDF format, replacing all previous versions effective February 1, 2020. The guide outlines critical submission procedures, including the exclusive use of digital forms to improve processing efficiency, the correct classification of urgency levels, and the necessity of verifying member ID accuracy. Furthermore, it advises providers on administrative best practices such as utilizing high-quality fax settings and maintaining updated records by frequently monitoring the HPSM authorization requirements list via the official provider portal to ensure compliance and timely service authorization.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/health-plan-of-san-mateo-prior-authorization-form-instructions-provider-guide/290025/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/health-plan-of-san-mateo-prior-authorization-form-instructions-provider-guide/290025.png","ImageObject",442,249,{"name":88,"@type":89},"Lucas Martin","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"When did HPSM stop accepting previous versions of the prior authorization form?","Question",{"text":108,"@type":109},"HPSM discontinued the use of previous versions of the form starting on February 1, 2020.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What are the technical requirements for completing the new form?",{"text":113,"@type":109},"Providers must complete all fields using the fillable PDF format rather than handwriting the information, and they are encouraged to set fax machines to the highest quality setting.",{"name":115,"@type":106,"acceptedAnswer":116},"How should providers handle requests for Long Term Care?",{"text":117,"@type":109},"Providers should use the specific Long Term Care box provided in the new form, ensuring they only check items within this section if the request is specifically for a long-term care stay.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},290025,1789973002,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","New Prior Authorization Form  \n1/21/2020  \nDear Provider,  \nHPSM has an updated prior authorization form, now available online through the HPSM website. This new form will help us process prior auth requests more efficiently. Please begin using this template as soon as possible, and review the tips below. HPSM will no longer accept the previous version of the form starting 2/1/2020.  \nPLEASE ALWAYS MAKE SURE THAT…  \nYou’re using the current version of the form: [https://www.hpsm.org/provider/authorizations](https://www.hpsm.org/provider/authorizations)  \n[Note: there](Note: there)’[s a separate box for Long Term](s a separate box for Long Term) Care authorization requests. Only check off  \nitems within this box if the request is for authorization of a long-term care stay:  \nOnly indicate “Urgent” if the service is urgent Marking  \nrequests for routine or scheduled care as urgent when they are not results in HPSM re-processing the request, which can delay our response time.  \n• You complete all fields using the fillable PDF (typed, not handwritten) .  \n• You use one form for one patient and double-check the member ID number before sending. Note that we cannot process more than one patient per form.  \n• You set your fax machine settings to the highest quality possible.  \n• You bookmark [https://www.hpsm.org/provider/authorizations](https://www.hpsm.org/provider/authorizations and)[ and](https://www.hpsm.org/provider/authorizations and) regularly check HPSM’s Prior Authorization Required list to determine if prior auth is required. It’s updated regularly (typically quarterly) .","cbCaigQGtOeLnTv7","https://ap.wps.com/l/cbCaigQGtOeLnTv7","pdf",286472,"English","# Prior Authorization Form Instructions\n## Submission Guidelines\n## Important Compliance Reminders","[{\"question\":\"When did HPSM stop accepting previous versions of the prior authorization form?\",\"answer\":\"HPSM discontinued the use of previous versions of the form starting on February 1, 2020.\"},{\"question\":\"What are the technical requirements for completing the new form?\",\"answer\":\"Providers must complete all fields using the fillable PDF format rather than handwriting the information, and they are encouraged to set fax machines to the highest quality setting.\"},{\"question\":\"How should providers handle requests for Long Term Care?\",\"answer\":\"Providers should use the specific Long Term Care box provided in the new form, ensuring they only check items within this section if the request is specifically for a long-term care stay.\"}]","Health Plan of San Mateo - Prior Authorization Form Instructions - Provider Guide | PDF",1789640011]