Eligibility and Benefits Verification

SCAN offers multiple options to verify member eligibility and benefits:

1. EDI 270/271 (preferred): Providers are encouraged to use the EDI 270/271 transaction as it is the most efficient option to obtain real-time member eligibility and benefit information. To get started:

• Contact your clearinghouse (add SCAN’s Payer ID: 10178) and PMS or HIS vendor
• For questions and connectivity testing, contact FinThrive at TUPrtnrSupt@finthrive.com or (877) 732-6853

2. Portal: Log in to Availity Essentials > select Patient Registration > Eligibility and Benefits Inquiry. There, you’ll find eligibility and benefits information updated daily, including but not limited to:

• Member eligibility confirmation
• Member’s ID#, status, and plan start date
• Medical group name and number

3. Managed File Transfer (MFT): Providers can receive downloadable eligibility files via MFT in one of two file formats:

• Flat file (recommended) provided/updated weekly
• 834 (if flat file cannot be ingested); frequency aligned upon with provider
  
  To get started, contact NetworkRelations@scanhealthplan.com.