Santa Clara

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Claims

Claims

Claims / EDI

For Providers that are not contracted ("Non-Contracted") with SCAN Health Plan, and your request for claim payment was denied: You have...

Clean Claim Edits Documents

Clean Claim Edits documents

Provider Compliance Resources

SCAN Health Plan’s commitment to compliance includes ensuring that its first tier, downstream, and related entities (FDRs) operate in compliance with applicable...

General Compliance and FWA Training Courses

All FDR employees who provide health or administrative services for Medicare members must take at least annually CMS’ general compliance training as well...

Report a Compliance Issue

Category: Report an Issue What is a Compliance Issue? A Compliance Issue is a suspected violation of a law, regulation, policy, or contract requirement...

SCAN Case Management Program Fact Sheets

Eligibility and Benefit Verification

Looking to save significantly on administrative costs? We offer three options for verifying eligibility and benefits. Industry studies confirm the easiest...

Patient Education Resources

Home safety checklist in English and Spanish