Scripps Health Plan Management Services Organization
This page contains information you can use to exchange healthcare transactions with Scripps Health Plan Management Services Organization using Stedi.
Use any of the following payer IDs to send transactions to Scripps Health Plan Management Services Organization using Stedi APIs or SFTP. Read the docs
Primary Payer ID
Stedi Payer ID
Payer ID aliases
,
Coverage types
Medical
Supported transactions
Use Stedi to exchange the following transactions with Scripps Health Plan Management Services Organization using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Not supported
Eligibility checks
(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Scripps Health Plan Management Services Organization.
Not supported
Coordination of benefits checks
(COB)
Submit coordination of benefit checks to Scripps Health Plan Management Services Organization to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Not supported
Real-time claim status
(276/277)
Check on the status of a claim previously submitted to Scripps Health Plan Management Services Organization in real-time by sending a claim status check (276/277).
Supported
Professional claims
(837P)
Submit professional claims to Scripps Health Plan Management Services Organization and receive 277 claim acknowledgments asynchronously.
Supported
Institutional claims
(837I)
Submit institutional claims to Scripps Health Plan Management Services Organization and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required
Claim payments
(835 ERA)
Receive electronic remittance advice (ERAs) from Scripps Health Plan Management Services Organization to review full payment details.
Enrollment process type
One-click
Activation timeframe
Days
Not supported
Dental claims
(837D)
Submit dental claims to Scripps Health Plan Management Services Organization and receive 277 claim acknowledgments asynchronously.
Not supported
Unsolicited claim attachments
(275)
Receive unsolicited attachments for claims submitted to Scripps Health Plan Management Services Organization.
Get started
Start processing healthcare transactions with Stedi and Scripps Health Plan Management Services Organization today.