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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 …
Documents
Amendment to Evidence of Coverage 2022 (pdf)
… update the Evidence of Coverage document to ensure it is … Scripps Scripps Health Plan These documents can be viewed, downloaded, and … accessing the 'I'm a Member' page: and 'Benefit Information & Forms' …
Documents
How to Become a SHPS Provider (pdf)
… to Provider Relations. Once your documentation is received you will be … County Z Please return completed documents via email: ProviderRelations@scrippshealth.org Subject …
Documents
2021 Annual Scripps Health Plan Mailing (pdf)
… your plan Evidence of Coverage document to ensure it is compliant … clarify the language in the document to make it more user …
Documents
Scripps Health Plan Services Compliance Plan SHP (pdf)
… by Extemal Agencies Accurate & Complete Documentation Coding Program (ACDC) Delegation Oversight … D Investigation and Conective Action Documentation. E. Investigation Closure S) Confidentiality …
Documents
2022 Annual Scripps Health Plan Mailing (pdf)
… plan 's Evidence of Coverage document to ensure it is compliant … clarify the language in the document to make it more user …
Documents
Grievance Resolution Program (pdf)
Scripps Health Plan has a grievance program designed to resolve its members' concerns or complaints in a timely and effective manner. Download this document to learn more about it.
Documents
2018 Amendment to Evidence of Coverage (pdf)
… updates its Evidence of Coverage document to ensure it is clear …
Documents
Electronic Fund Transfer (EFT) Form (pdf)
This document allows you to sign up for electronic fund transfers with Scripps Health Plan Services.
Documents
2020 Amendment to Evidence of Coverage (pdf)
… updates its Evidence of Coverage document to ensure it is clear …
Documents
Care Management Referral Form (pdf)
… issues Form with any supporting documentation may be email or faxed …
Documents
SHPS 1601 Colorectal Cancer Screening (pdf)
… 1601 Scripps Health Plan Services Page 1 of 2 TITLE: … reviewer follows standard referral determination, documentation and notification requirements _ GUIDELINE … 1601 Date: 08/26/21 Page 2 of 2 V. …
Documents
Amendment to Evidence of Coverage 2024 (pdf)
Download this PDF to review the changes to Scripps Health Plan Evidence of Coverage document.
Documents
Evidence of Coverage 2025 (pdf)
Evidence of coverage document for the year 2025.
Documents
Scripps Health Plan Quality Management Program Description (pdf)
This is a document with the program description of the quality management program for Scripps Health Plan.
Documents
Scripps Health Plan Utilization Management Program Description (pdf)
This is a document for the program description for utilization management of Scripps Health Plan.
Documents
Potential Quality Issue FAQs (pdf)
This document outlines frequently asked questions related to potential quality issues (PQI).
Documents
Formulary April 2025 (pdf)
This document is the drug formulary for the month of April 2025 for Scripps Health Plan members.
Documents
Prior Authorization Request Form (pdf)
The Prior Authorization Request Form allows Scripps Health Plan providers to request approval for services for which authorization is required in advance.
Documents
Corrected Claims Form (pdf)
The Corrected Claim Form allows providers to amend an existing claim, including corrected diagnoses, provider information, charges and more.