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 and most cost-effective way for providers to verify eligibility and benefits is through EDI, followed by portal verification. Telephonic verification can cost from two to six times more per transaction. Make the switch today!

ASC X12N Healthcare Eligibility Benefit and Response (270/271):
Providers can adopt the fully electronic HIPAA standard, the 270/271 Eligibility, Coverage and Benefit Inquiry transaction to automatically generate an inquiry to enable automatic posting of the benefit information to the patient’s account. Contact your software vendor or clearinghouse. Eligibility transactions may be integrated into your PMS or HIS, if available.

SCAN’s Provider Portal:https://secure-pportal.scanhealthplan.com
Provides SCAN’s contracted and non-contracted providers instant access to a member’s latest eligibility, benefits and EOC information without needing to pick up the phone. (If you are an employee of a SCAN-contracted Medical Group or IPA, please contact your organization’s portal administrator for access. Please do not use the self-registration option.)

SCAN’s Telephonic Eligibility Verification (IVR) Automated Line: Call (877) 778-7226, accessible 24/7
You can obtain the Medical Group/IPA name and number, and Medical Group/IPA claim forwarding address using the IVR system. There will be a prompt that asks: “Would you like the Group address and phone number?” Respond “yes”, and you will be provided the information.