SCAN Health Plan provides its members with access to a broad network of healthcare providers, ensuring comprehensive medical care. Understanding how to navigate this network is key to maximizing your SCAN benefits. This article will guide you on how to find doctors and healthcare partners within the SCAN network.
Understanding SCAN’s Healthcare Network
SCAN operates with a network of primary care physicians, specialists, hospitals, and various other healthcare providers. For routine medical care, it is generally required to utilize providers within the SCAN network. This in-network approach helps manage costs and ensures coordinated care. However, exceptions are made for emergency or urgent care situations, as well as for out-of-area renal dialysis. It’s important to note that if you seek routine care from providers outside of the SCAN network without prior authorization, neither Medicare nor SCAN will cover the expenses. Specific exceptions to this rule apply to VillageHealth plans in Riverside and San Bernardino counties (California), and Embrace plans in San Bernardino County (California) and Maricopa and Pima counties (Arizona). For detailed information regarding these exceptions, members are advised to consult their plan’s Evidence of Coverage (EOC) or contact SCAN directly. Keep in mind that SCAN’s formulary, pharmacy network, and provider network are subject to change, with necessary notifications provided to members.
How to Find a Doctor with SCAN
Locating a doctor within the SCAN network is a straightforward process. SCAN offers several resources to assist you in finding the right healthcare provider:
1. Utilize the Online Plan Search Tool:
SCAN’s online Plan Search Tool is an efficient way to check plan availability in your county and search for providers. By entering your zip code, you can determine the SCAN plans available in your area and explore the associated provider networks. This tool is particularly useful for prospective members looking to understand their healthcare options.
2. Contact SCAN Member Services (For Existing Members):
Current SCAN members can directly contact Member Services for personalized assistance in finding a doctor or verifying network status. You can reach SCAN Member Services at 1-800-559-3500 (TTY: 711). Operating hours are from 8 a.m. to 8 p.m., seven days a week between October 1 and March 31. From April 1 to September 30, hours are 8 a.m. to 8 p.m., Monday through Friday.
3. Contact SCAN Telesales (For Prospective Members):
Individuals interested in becoming SCAN members and exploring their provider options can contact SCAN Telesales at (877) 452-5898 (TTY: (888) SCAN-TTY). The Telesales team can provide information on available plans and guide you through the process of finding a doctor within the network that meets your needs.
Messages left during holidays or outside of business hours will be addressed on the next business day, ensuring timely support.
Access Standards and Wait Times for Healthcare Services
SCAN is committed to providing timely access to essential healthcare services. The following guidelines outline the maximum wait times you can expect for primary care and behavioral health services:
- Emergency or Urgently Needed Services: Immediate access is provided.
- Non-Emergency, Medically Necessary Services: Access within 7 days.
- Routine and Preventative Care: Access within 30 days.
These standards ensure that SCAN members receive the necessary care in a timely manner, whether it’s for urgent medical needs or routine health maintenance.
Conclusion
Finding a doctor within the SCAN Health Care Partners network is made easy through online tools and direct contact options. By utilizing these resources, both current and prospective members can confidently navigate their healthcare choices and ensure they receive quality, in-network care. For further assistance or to explore plan options, don’t hesitate to visit the SCAN website or contact their dedicated service teams.
