- Provider Manuals for Medi-Cal and Healthy Kids and Cal MediConnect—Tools to help you and your staff most efficiently and effectively work with us. It also provides contact information for reaching SCFHP staff.
- Quick References for Medi-Cal and Healthy Kids and Cal MediConnect—Contain SCFHP contact information and instructions for claims, authorizations, and eligibility.
- Provider memos
- Provider training
- Clinical guidelines
- Initial health assessment
- Submitting a claim or dispute
- Information about fraud, waste, and abuse and how to report
- Alcohol Use Disorder Identification Test (AUDIT)
Frequently asked questions
Advance Healthcare Directive
In order to designate a healthcare representative in the case of incapacitation, a member must fill out an Advance Healthcare Directive form. The directive details the types of treatment a member wishes to receive or avoid and allows a member to designate a healthcare agent. The healthcare agent can make health-related decisions if the member is no longer able to make these decisions. The member's rights as a SCFHP health plan member apply to this designated healthcare agent.
The Advance Healthcare Directive Form can be downloaded here.
Community resources for your patients
Occasionally, your patients may need help from local community services. Please visit our Community Resources page to access descriptions and contact information for local community organizations. This information is provided as a public service. SCFHP is not a sponsor of the organizations or events referenced in Community Resources.
Fraud, Waste & Abuse Resources
Review Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians, published by the Centers for Medicare and Medicaid Services (CMS).
Medicare Learning Network for providers
The Medicare Learning Network® (MLN) is the home for education, information, and resources for the healthcare professional community. The MLN provides access to CMS Program information you need, when you need it, so you can focus more on providing care to your patients.
Serving as the umbrella for a variety of CMS education and communication activities, the MLN offers:
- MLN Educational Products, including MLN Matters® Articles
- MLN Connects® National Provider Call Program (many offer Continuing Education credits)
- MLN Connects® Provider Association Partnerships
- MLN Connects® Provider eNews
- Provider electronic mailing lists
The following resources are provided by the Centers for Medicare and Medicaid Services (CMS) Medicare Learning Network (MLN).
- HIPAA Basics for Providers: Privacy, Security, and Breach Notification Rules
- Medical Privacy of Protected Healthy Information—Guide to the latest provisions that strengthen the privacy and security protections for health information established under HIPAA