Information for Providers

Scripps Health Plan HMO Provider click here.

This section is intended for EPO Provider use only.

If you are a member and would like to search for a Provider click here.

With the administration of Scripps Medical Plans moving to HealthComp for the EPO plan effective January 1, 2010, physician offices should use Myscrippshealthplan.com for pre-certification, eligibility verification and claims questions or call 1-877-552-7247.

Provider Notes:

The Scripps Custom Provider Network community may refer patients to Scripps Health Labs, Quest Diagnostics, Laboratory Corporation or San Diego Pathology for lab services.

Covered services must be performed at a Scripps Imaging Center facility except basic x-rays performed in a physician’s office, OB ultra-sounds performed in a physician’s office and pediatric services. For a list of Scripps Imaging Center locations, please contact the Scripps Imaging Center at 888-440-7882.

Provider Pre-Certification

For the EPO plan: A printable pre-certification form in PDF format that can be filled out and faxed directly to the Scripps Medical Plans Member Service Center at 559-243-7012.

Download the Pre-certification Request Form

Provider Claim Search

For EPO plan: Secure provider search for claim status.

Procedure Code Fee Schedule Search

This section is intended for Provider use. If you are a member and would like to search for a Provider click here.

For EPO plan: Fee schedule search for current reimbursement rate, simply type in the procedure code to get the rate.