Claim Overpayment & Recovery
Options for Overpayment & Recovery
- Please refer to SCAN’s overpayment options below for a SCAN identified or Provider identified overpayment. Our recoupment process applies to Contracted Providers only.
- Inquiries or disputes should be emailed to SCAN’s Claims Recovery Unit: Claimsrecoveryunit@scanhealthplan.com.
SCAN Identified Overpayment
SCAN reviews payment data regularly which occasionally results in identification of overpaid claims. When an overpayment is identified, SCAN will send an Overpayment Notice Letter to the provider. The notice will include the reason for the overpayment and request for refund.
- Providers have Sixty (60) calendar days from the date of the notice to reimburse SCAN with the repayment amount.
- Providers can dispute the request by emailing Claims Recovery at Claimsrecoveryunit@scanhealthplan.com.
- If SCAN does not receive payment in full within Sixty (60) calendar days of the letter, overpayment amounts may be withheld (recouped) until overpayment is recovered.
Instructions:
- Complete and print the Provider Overpayment Refund Request Form
- Mail the check, the Provider Overpayment Refund Form, the Overpayment Notice and other documentation to: SCAN Health Plan, 3800 Kilroy Airport Way, Suite 100, Long Beach, CA 90801
- Send notification or inquiries directly to: Claimsrecoveryunit@scanhealthplan.com
Provider Identified Overpayment
Providers are required to report any payments made by SCAN for which the provider is not entitled. Overpayments must be returned to SCAN no later than Thirty (30) calendar days after the date which the overpayment was identified.
- Providers should notify SCAN in writing via the Provider Overpayment Refund Request Form including Member Claim Payment details, Provider Information, and Contract information.
- Providers have the option of returning overpayments via check to SCAN or may elect recoupment/offset of the overpayment from future payments (contracted providers only).
Instructions:
- Complete and print the Provider Overpayment Refund Request Form
- Mail the check, the Provider Overpayment Refund Request Form along with any other documentation to: SCAN Health Plan, 3800 Kilroy Airport Way, Suite 100, Long Beach, CA 90801
- For inquiries or overpayment notification, please contact SCAN Claims Recovery team at: Claimsrecoveryunit@scanhealthplan.com
Claim Recovery Recoupment Offset Contracted Providers Only
Contracted providers may elect to have overpayment(s) repaid through the recoupment processes, instead of submitting a check to SCAN.
- Recoupment of Overpayment: SCAN will implement a recoupment of identified over payments Thirty (30) calendar days after the identification of the overpayment or notification of the overpayment by the provider. This process will occur in situations where the overpayment amount has not been received by SCAN by the 30th day.
- Immediate Recoupment: Providers can elect the recoupment process as soon as the overpayment is identified. Requests must be received no later than Fifteen (15) days after the identification of the overpayment.
NOTE: Details of overpayment recoupment can be found in the Overpayment Notification or by contacting SCAN Claims Recovery Unit at: Claimsrecoveryunit@scanhealthplan.com
Instructions:
- For immediate recoupment option, please email the completed Provider Recoupment Request Form to: ClaimsRecoveryUnit@Scanhealthplan.com
- For additional submission options, email: ClaimsRecoveryUnit@Scanhealthplan.com
