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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
SHPM1
Stedi Payer ID
SGVFC
Payer ID aliases
1199, SHPM1
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.
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
Use Stedi's APIs to get fast and reliable connectivity to Scripps Health Plan Management Services Organization and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Scripps Health Plan Management Services Organization today.
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