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.

Embrace Member ID Card & Embrace POS Passport/Resource card

View of SCAN Desert Health Plan cards.

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