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Prescription Drug Coverage

Scripps Health Plan makes it easy for members to manage your prescriptions, with convenient options like our mail order service and 90-day refills.
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Benefit Information

Scripps Health Plan members can easily download the forms and documents you need to understand your coverage and manage your health care.
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Care Management

Scripps Health Plan members have access to mental health and substance abuse services as well as chronic disease management tools. Learn more.

Continuity of Care

Eligible Scripps Health Plan members have certain rights during transitions of care, for example when treatments are disrupted by a doctor leaving our network.

Preventing Fraud

Learn how Scripps Health Plan in San Diego prevents health care fraud, waste and abuse - and how you can report a concern.

Prior Authorizations

Learn more about medical services that require prior authorization from Scripps Health Plan, and how our review and approval process works.

Confidentiality

Learn how Scripps Health Plan protects your medical information, and how can you designate someone to receive medical information on your behalf.

Language Assistance Program

Scripps Health Plan offers interpreter and translation services for members who speak limited English, and TTY/TDD access for the hearing or speech impaired.

Provider Directory Updates

Scripps Health Plan members who notice incorrect or missing entries in our provider directory can submit changes through our website.

Provider Directory Changes

Contracted providers can quickly and easily update your listing in our Scripps Health Plan provider directory. Submit your changes online.

Your Privacy

Learn how Scripps Health Plan keeps our members’ medical information safe and confidential.

Member Rights & Responsibilities

Learn more about Scripps Health Plan policies and procedures, as well as your rights and responsibilities as a plan member.

Network Map

Learn more about Scripps Health Plan’s extensive network in San Diego County, and look up affiliated providers and locations.
I'm a Member > Benefit Information

Gym Membership Program

Active&Fit Direct program allows Scripps Health Plan members to get discounted memberships at participating fitness centers nationwide.
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Member Notices

Find current and past member notices pertaining to your Scripps Health Plan benefits.

COVID-19

In response to the spread of coronavirus (COVID-19), Scripps Health Plan is taking steps to reduce costs and extend access to care. Learn more about changes.

Transparency in Coverage

Centers for Medicare & Medicaid Services’ Transparency in Coverage Rule requires group health plans to provide cost-sharing data to consumers.
Documents

SHP Medical Record Documentation Standards Tip Sheet (pdf)

… accepted standards for medical record documentation. Each page or electronic medical record … address these barriers to care. Documentation that demonstrates continuity and coordination …
Documents

SHPS 1602 Treatment of Varicose Veins - Venous Insufficiency (pdf)

… Scripps Health Plan Services Page 1 of 5 TITLE: … Date: 10/28/21 Page 2 of 5 Hemorrhage … the sarne session (or have documentation submitted when that should … Date: 10/28/21 Page 3 of 5 sclerotherapy ( …
Documents

Standard MedPerform Guidelines (pdf)

… All rights reservecL This document is proprietary to P& … interestin and to this document. Revised: 11/12/2021 … PAGE Copyrights 2022 Medlmpact Healthcare Systems, Inc All rights reservecL This document