Plantillas de cartas
Comuníquese con:
Contacto de Manejo de calidad de SCAN:
Charia Ben
Auditora de cumplimiento de redes
Correo electrónico: DOSubmissions@scanhealthplan.com
- Coverage Decision Letter English
- Coverage Decision Letter Spanish
- Denial of Coverage for Inpatient Hospitalization Provider Denial Última modificación: 8/9/2016
- Detailed Explanation of Non Coverage English Última modificación: 5/3/2019
- Detailed Explanation of Non Coverage Spanish Última modificación: 5/3/2019
- Detailed Explanation of Non Coverage Chinese Última modificación: 5/3/2019
- Detailed Notice of Discharge English Última modificación: 8/9/2016
- Detailed Notice of Discharge Spanish Última modificación: 8/9/2016
- Detailed Notice of Discharge Chinese Última modificación: 11/21/2018
- Detailed Notice of Discharge Korean U12020
- Extension Needed For Additional Information English Última modificación: 8/9/2016
- Extension Needed For Additional Information Spanish Última modificación: 8/9/2016
- Extension Needed For Additional Information Chinese Última modificación: 8/9/2016
- Important Message From Medicare About Your Rights English Última modificación: 8/9/2016
- Important Message From Medicare About Your Rights Spanish Última modificación: 8/9/2016
- Important Message From Medicare About Your Rights Chinese Última modificación: 11/21/2018
- Important Message From Medicare Korean U1 2020
- Informational Letter To Beneficiary And Or Provider Physician English Última modificación: 8/9/2016
- Informational Letter To Beneficiary And Or Provider Physician Spanish
- Informational Letter To Beneficiary And Or Provider Physician Chinese Última modificación: 8/9/2016
- Informational Letter To Beneficiary And Or Provider Physician Korean
- Medicare Outpatient Observation Notice MOON English Última modificación: 2/10/2017
- Medicare Outpatient Observation Notice MOON Spanish Última modificación: 2/10/2017
- Medicare Outpatient Observation Notice MOON Chinese Última modificación: 3/8/2017
- Medicare Outpatient Observation Notice MOON Korean
- CA Notice of Authorization Facility English U2 2021
- CA Notice of Authorization Facility Spanish U2 2021
- CA Notice of Authorization Facility Chinese U2 2021
- Notice of Authorization Services English
- Aviso de rechazo de cobertura médica Español Última modificación: 5/1/2019
- Notice of Authorization Services Chinese
- Notice of Denial of Medical Coverage English
- Aviso de Denegación de Cobertura Médica en Español Última modificación: 5/1/2019
- Notice of Denial of Medical Coverage Chinese
- Notice of Denial of Medical Coverage Korean U2 2020
- Notice of Dismissal of PreService Request English
- Notice of Dismissal of PreService Request Spanish Última modificación: 3/8/2019
- Notice of Dismissal of PreService Request Chinese
- CA Notice of Dismissal of PreService Request Korean
- Notice of Medicare NonCoverage English Última modificación: 8/9/2016
- Notice of Medicare NonCoverage Spanish Última modificación: 8/9/2016
- Notice of Medicare NonCoverage Chinese Última modificación: 8/9/2016
- Notice of Medicare NonCoverage Korean
- Notice of Reinstatement of Coverage English Última modificación: 8/9/2016
- Notice of Reinstatement of Coverage Spanish Última modificación: 8/9/2016
- Notice of Reinstatement of Coverage Chinese Última modificación: 8/9/2016
- CA Optional Form to Document Alternate Delivery
- Second and Third Opinion Authorization English
- Second and Third Opinion Authorization Spanish
- Second and Third Opinion Authorization Chinese
- Section 1557 Notice Multi Language English
- Section 1557 Notice Multi Language Spanish
- Section 1557 Notice Multi iLanguage Chinese
- Section 1557 Notice MultiLanguage Korean
- Services Requested Do Not Meet Expedited Criteria English Última modificación: 8/9/2016
- Services Requested Do Not Meet Expedited Criteria Spanish Última modificación: 8/9/2016
- Services Requested Do Not Meet Expedited Criteria Chinese Última modificación: 8/9/2016
