Showing 61-80 results of 99 total
Documents

Member Claim Reimbursement Form (pdf)

The Member Claim Reimbursement Form is for direct reimbursement to members for covered medical benefits under Scripps Health Plan.
Documents

Member Welcome Guide (pdf)

The Member Welcome Guide is intended to assist new Scripps Health Plan members with questions they may have regarding access to health care services.
Documents

Network Medical Group Contacts (pdf)

Find a list of medical groups that are part of the Scripps Health Plan network along with addresses, email addresses and phone numbers for each.
Documents

Notice of Privacy Practices (pdf)

The Notice of Privacy Practices describes how medical information about you may be used and disclosed, and how you can access this information.
Documents

Prior Authorization Guide (pdf)

The Prior Authorization Guide identifies services that require approval or authorization before members can receive them.
Documents

Provider Operations Manual (pdf)

The Scripps Health Plan Provider Operations Manual contains key contacts within the health plan and other information designed to help providers navigate the plan.
Documents

Scripps Care Link Form (pdf)

Scripps Care Link Access Request Form should be completed by Scripps Health Plan affiliated providers who need access to data from Scripps information systems.
Documents

Coordination of Benefits Form (pdf)

The Coordination of Benefits (COB) form is used to gather information about whether members or their dependents are covered under more than one health plan.
Documents

Continuity of Care Request Form (pdf)

Continuity of Care Request Form to provide continuity of care for new enrollees who are undergoing an Active Course of Treatment from a nonparticipating provider.
Documents

Evidence of Coverage (pdf)

This is a summary benefit description for Scripps Health Plan, which briefly describes your coverage, followed by comprehensive benefit descriptions.
Documents

Summary of Benefits and Coverage (pdf)

Learn more about the Summary of Benefits and Coverage, including what the plan covers and what you pay for covered services.
Documents

Prescription Drug Prior Authorization Request (pdf)

Prescription drug prior authorization request form supports the prior authorization or step-therapy exception requests.
Documents

Provider Dispute Resolution Form (pdf)

The provider dispute resolution form provides space for the member to give supporting information in regards to their dispute.
Documents

MedImpact Direct Specialty Brochure (pdf)

The Medlmpact Direct Specialty program brochure provides patients with information about the program, what benefits they will receive and who to contact for questions.
Documents

Doctor On Demand (pdf)

Learn more about Doctor on Demand.
Documents

2019 Annual Scripps Health Plan Mailing (pdf)

Read the welcome letter sent to those who selected the Scripps Health Plan HMO as their plan for 2019. Learn more about your benefits, changing PCPs, finding a provider and customer support.
Documents

MyScripps Account Member Notice (pdf)

Scripps Health Plan encourages members to enroll in MyScripps and take advantage of the tools and features it offers.
Documents

2017 Amendment to Evidence of Coverage (pdf)

Learn more about Scripps Health Plan's amendment to the Evidence of Coverage (EOC) to meet MHPAEA, also known as the Mental Health Parity and Addiction Equity Act of 2008.
Documents

2020 Annual Scripps Health Plan Mailing (pdf)

Read the welcome letter sent to those who selected the Scripps Health Plan HMO as their plan for 2020. Learn more about your benefits, changing PCPs, finding a provider and customer support.
Documents

Scripps Health Ambulatory Pharmacy Mail Order Medication Form (pdf)

To have prescribed medications filled and mailed to you by Scripps Outpatient Pharmacies, download, fill out and fax the Scripps Health Ambulatory Pharmacy Medication Order Form.