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Operational updates due to COVID-19

Provider news | Monday, April 6, 2020

Our operations are continuing during the shelter in place order to maintain services and support for our members and providers. 92% of our staff are now working from home, and our lobby is closed to visitors until further notice. Please refer members to the Santa Clara Family Health Plan (SCFHP) Customer Service phone numbers for help:
• Medi-Cal: 1-800-260-2055
• Cal MediConnect: 1-877-723-4795

We have a 24/7 nurse advice line available to members, and we are working to integrate a telehealth component to this service:
• Medi-Cal: 1-877-509-0294
• Cal MediConnect: 1-844-803-6962

Telehealth services
SCFHP will reimburse Cal MediConnect and directly contracted providers for Medi-Cal at contracted rates for medically appropriate covered services, whether the service is provided in-person or through telehealth. For more information, including how to bill, please check the March 27 memo.

Prior authorization for directly-contracted providers
As of March 31, the suspension of all provider-requested medical (inpatient and outpatient), pharmaceutical, and durable medical equipment prior authorization requests will be extended until April 30. For more information, check the March 31 memo.

For any provider inquiries, please contact Provider Services at providerservices@scfhp.com or call 1-408-874-1788. If you are closing your facility or office, contact Provider Services immediately.

Self-service tools

The following self-service tools are available to you and are not dependent on speaking to a Customer Service Representative:

Provider Link: providerportal.scfhp.com
Check authorizations and claims status
Verify member eligibility
Download your member rosters

Interactive Voice Response (IVR) at 1-408-874-1473
Verify member eligibility
Check claims status based on your TIN
Request fax confirmation of eligibility verification or claim(s) processed


You will find the most recent provider information and resources relating to the coronavirus at www.scfhp.com/coronavirus-providers.