Billing & Reimbursement

SCAN Health Plan Provider Portal: Login,

Use SCAN Health Plan

Why this matters

SCAN Health Plan portal work is easier to manage when eligibility findings, authorization status, claim follow-up, denial notes, and documentation ownership stay connected to the admission.

For treatment centers

Payer portals answer part of the workflow

The SCAN Health Plan portal may show eligibility, authorization status, claims, or messages from the payer. helps your team keep those findings connected to the admission, documentation, follow-up, and billing work around them.

Where helps

If your facility uses, VOB details, authorization status, payer routing, claim follow-up, denial notes, and documentation ownership can travel with the record instead of living across screenshots, spreadsheets, and inboxes.

What stays with the payer

SCAN Health Plan still controls portal access, coverage rules, authorization decisions, and payment decisions.

Portal at a glance

SCAN Health Plan is a nonprofit Medicare Advantage organization serving CA, AZ, NV, NM, and TX. Provider guide for behavioral health credentialing and billing.

Provider portal: https://www.scanhealthplan.com/providers
Insurance profile: View SCAN Health Plan profile →
Also known as: SCAN Group (nonprofit)
Parent company: SCAN Group (nonprofit)
Credentialing context: CAQH ProView (primary) with SCAN provider enrollment application · 60-90 days from completed application
Operating states: CA · AZ · NV · NM · TX

Daily portal workflows for treatment centers

Eligibility and VOB

Start with active eligibility, network status, cost-share, and whether the levels of care listed on the SCAN Health Plan profile are covered for the member: Inpatient Psychiatric Hospitalization · Partial Hospitalization Program (PHP) · Intensive Outpatient Program (IOP) · Outpatient Mental Health and SUD Treatment · Medication-Assisted Treatment (MAT).

Prior authorization

Use the profile criteria as the intake checklist before submitting an authorization request: CMS Medicare Advantage medical necessity standards · ASAM Criteria (for SUD level of care placement) · SCAN proprietary clinical review guidelines · InterQual or equivalent criteria for inpatient psychiatric admissions. Keep the clinical packet aligned with the portal's required fields.

Claim status and follow-up

After claim submission, use the portal to tie each follow-up back to the member eligibility response, authorization record, rendering or facility identifiers, and the payer routing confirmed during VOB.

Credentialing updates

Keep portal access aligned with credentialing context from the profile: CAQH ProView (primary) with SCAN provider enrollment application · 60-90 days from completed application. New locations, tax IDs, and roster changes should not wait until a claim denies.

What to verify before admission

Confirm active coverage, network status, plan type, member responsibility, and the specific payer route attached to the member's plan.
Match the requested level of care against the profile's covered levels of care: Inpatient Psychiatric Hospitalization · Partial Hospitalization Program (PHP) · Intensive Outpatient Program (IOP) · Outpatient Mental Health and SUD Treatment · Medication-Assisted Treatment (MAT).
Prepare clinical documentation against the listed medical necessity criteria: CMS Medicare Advantage medical necessity standards · ASAM Criteria (for SUD level of care placement) · SCAN proprietary clinical review guidelines · InterQual or equivalent criteria for inpatient psychiatric admissions.
Check whether the member's state, product, or network arrangement changes portal access, payer routing, or authorization requirements.
Use the SCAN Health Plan insurance profile as the source page for credentialing, coverage, and payer-specific operating context.

Authorization and documentation notes

Treat the portal workflow as an admission-control checkpoint: the eligibility response, authorization request, clinical packet, and claim setup should all tell the same story before the first billed date of service.

For SCAN Health Plan, the profile lists medical necessity criteria that should shape the clinical packet: CMS Medicare Advantage medical necessity standards · ASAM Criteria (for SUD level of care placement) · SCAN proprietary clinical review guidelines · InterQual or equivalent criteria for inpatient psychiatric admissions. Build the request around those criteria instead of relying on a generic treatment summary.

Credentialing context from the profile is also operational context for the portal: CAQH ProView (primary) with SCAN provider enrollment application · 60-90 days from completed application. Keep provider, facility, location, and tax ID records synchronized before claims go out.

Profile FAQs to keep nearby

What states does SCAN Health Plan operate in and where is it headquartered?

SCAN Health Plan is headquartered in Long Beach, California, and operates as a Medicare Advantage plan in California, Arizona, Nevada, New Mexico, and Texas as of 2025. SCAN is one of the largest nonprofit Medicare Advantage organizations in the western United States, serving a predominantly senior and dual-eligible member population. SCAN is affiliated with the SCAN Group, a nonprofit holding company, but is not related to the SCAN Foundation despite sharing a common historical name lineage. Network needs and credentialing acceptance vary by service area and specialty — contact SCAN provider relations to confirm whether your geographic area has current network openings.

How does SCAN Health Plan's behavioral health prior authorization process work?

As a Medicare Advantage plan, SCAN Health Plan requires prior authorization for most behavioral health services beyond standard outpatient therapy. Inpatient psychiatric hospitalization, partial hospitalization programs (PHP), and intensive outpatient programs (IOP) generally require pre-admission or admission-day authorization. Submit authorization requests through the SCAN provider portal at scanhealthplan.com/providers. Clinical documentation should address CMS Medicare Advantage medical necessity standards and, for SUD admissions, should speak to ASAM Criteria dimensions. Concurrent reviews apply for continued stay authorization. SCAN follows CMS-required timeframes for authorization decisions: 72 hours for urgent requests and 14 calendar days for standard requests.

What is the timely filing window for SCAN Health Plan claims?

For contracted (in-network) providers, the timely filing deadline for SCAN Health Plan claims is generally set by the provider agreement — most SCAN provider contracts specify 90 days from the date of service, though this can vary by contract. For non-contracted providers, CMS rules apply: the timely filing window for Medicare Advantage claims is one calendar year from the date of service, per CMS regulations. Claims submitted after the applicable timely filing deadline are denied and generally do not have appeal rights, so prompt submission is strongly recommended. Always confirm your specific contracted deadline by reviewing your SCAN provider agreement.

Claims, denials, and follow-up

Claims and status workflows vary by plan, state, and network arrangement. Start with the SCAN Health Plan provider portal or the payer instructions listed on the insurance profile, then confirm member-specific payer routing, authorization requirements, and claim format before billing.

Before claim submission, confirm the payer route, authorization number, billed level of care, rendering and facility identifiers, date range, and whether another payer is primary. When a claim stalls, work backward from the portal record to the VOB, authorization, and documentation packet.

Where fits after the portal

The SCAN Health Plan portal may answer one part of the case. helps treatment centers keep portal findings connected to admissions, clinical documentation, authorization status, claim follow-up, and denial work.