SCAN Resources

Learn more about our health plan in partnership with SCAN, including resources for claims and authorizations such as PCP claims, specialist/ancillary/facility claims, and referrals/authorizations.

PCP Claims Specialist/Ancillary/Facility Claims Referral/Authorizations

PCP Claim Options

You may submit PCP claims by mail, fax, or EDI.

  • Mail Claims

Send claims to:

Phoenix Physicians IPA c/o MSO Inc. of Southern California

2670 N. Main St., Ste. 100, Santa Ana, CA. 92705

  • Fax Claims

Fax to: (626) 552-3760

  • EDI

Information: TBA

For questions about claims, please email  Ldo@MsoSocal.com or call 818-726-5278.

Specialist/Ancillary/Facility Claim Options

  • Submit Through Your Clearinghouse
  • Use the correct claim format:
  • Professional claims: 837P (CMS‑1500 format)
  • Facility claims: 837I (UB‑04 format)
  • In your Clearinghouse, select SCAN Health Plan as the payer.
  • Confirm the correct payer ID with your clearinghouse or the SCAN Provider Manual, as payer IDs may vary by region or product.
  • Be sure to include all required information:
  • Member ID exactly as shown on the SCAN card
  • Rendering and billing NPI (and taxonomy, if required)
  • Dates of service
  • CPT/HCPCS/Revenue codes
  • Diagnosis codes (ICD‑10)
  • EDI
  • SCAN1

Referral/Authorization Steps

To submit an authorization request to SCAN, follow these steps:

1. Access Availity Essentials

Use the Authorizations application within Availity Essentials to begin your request.

2. Identify Services Requiring Prior Authorization

Review SCAN’s prior authorization lists to determine which services require approval.

Referral Guidance (In-Network Medical Group Providers)

  • Initial E/M visits (99202–99205)
  • Do not require authorization when referring to an in‑network provider within the medical group/IPA.
  • Follow‑up visits (99212–99215)
  • Require prior authorization and must be approved before the visit.

3. Submit the Request

Use the ICR (Interactive Care Reviewer) tool in Availity Essentials to submit your authorization request.

4. Check Authorization Status

Access the ICR tool through Availity Essentials to view request status, updates, or determination decisions.

5. Contact Provider Services

For assistance, contact SCAN Provider Services at  1‑877‑452‑5898, available Monday–Friday, 8 a.m.–5 p.m., excluding state‑observed holidays. For additional information and resources, visit the SCAN Provider Website or  contact their Provider Services team.