Streamline your claims

We make it easy for care providers to submit claims electronically through one of our trusted clearinghouse partners – Change Healthcare and Office Ally. Submit, get reimbursed and get on with the important stuff — caring for your patients.


Submit a claim using Change Healthcare

Please contact your vendor to add Payor ID 33099.


Submit a claim to Office Ally

Scripps Health Plan’s Client ID number is: SHPM1. You must register to submit claims electronically through Office Ally.


To register, call 360-975-7000 and select option 3.


Complete the enrollment request form online for new users. Providers already registered with Office Ally should call 360-975-7000 option 1 for answers to questions related to claims submission.


Please remember to follow instructions below when submitting your claims to ensure acceptance.


Institutional claims direct entry

When submitting your claim, be sure you are using the correct type of bill code, such as for services with locations of inpatient, outpatient hospital, skilled nursing and home health, etc.


Special or unique billing codes

A provider whose contract has the approval to use special billing or unique billing codes, please follow these instructions:


  • Special billing code(s) are to be sent at the line level (2400 loop) or the 837 claim file 
  • Specify the 2400 NTE segment with qualifier of ADD (e.g.NTE*ADD*EP)
  • In cases where a description needs to be sent along with the code, the caret character (^) needs to be added to separate the code from the description
  • All other 5010 Requirements are to be followed


Paper claims and corrected claims submission

You may mail your claims to the following address:


Scripps Health Plan

Attention: Claims

P.O. Box 2529

La Jolla, CA 92038


Claims requiring corrections must be submitted with a Resubmission code number 7 in Field 22 on the CMS 1500 and filed 4 on the UB-04. The original claim number is required.  

 

Scripps Health Plan is more than an insurance plan — it’s a new way for providers like you to connect with your patients and make a real difference in their lives. Our fully integrated care model means that every part of our team is pulling in the same direction — toward better outcomes, smoother processes and a more streamlined health care experience for all.