Santa Clara Family Health Plan provider portal, phone and payer ID quick facts
| Provider resource entry point | https://providerportal.scfhp.com/ |
|---|---|
| Payer contact reference | 1-408-874-1788The provider/claims resource lists 408-874-1788. |
| Claims payer ID | 24077 — Direct-to-SCFHP claims, not all delegated network claims. |
| Eligibility payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Santa Clara Family Health Plan. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| Timely filing | One calendar year; delegated rules may differ |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- The provider/claims resource lists 408-874-1788.
- For claims governed by the reviewed SCFHP instructions, file within one year from service; secondary claims use one year from the primary payer EOB. Preserve calendar-year wording and confirm delegated contracts.
- This registry has not established a payer-specific appeal ladder for Santa Clara Family Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
- This registry has not established one national ERA payer ID for Santa Clara Family Health Plan. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment.
Santa Clara Family Health Plan at a glance
| Legal name | Santa Clara Family Health Plan |
|---|---|
| Also known as | SCFHP |
| Category | Medicaid MCO |
| Parent organization | Santa Clara Family Health Plan |
| Claims payer ID | 24077 — Direct-to-SCFHP claims, not all delegated network claims. |
| Eligibility (270/271) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Santa Clara Family Health Plan. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| NAIC company code | Not established in this registry |
| States covered | California |
| Provider resource entry point | https://providerportal.scfhp.com/ |
| Provider phone | 1-408-874-1788The provider/claims resource lists 408-874-1788. |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Santa Clara Family Health Plan
For claims governed by the reviewed SCFHP instructions, file within one year from service; secondary claims use one year from the primary payer EOB. Preserve calendar-year wording and confirm delegated contracts.
| Submission type | Window |
|---|---|
| Initial claim reference | One calendar year; delegated rules may differ |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Santa Clara Family Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Santa Clara Family Health Plan provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Santa Clara Family Health Plan
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Santa Clara Family Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Santa Clara Family Health Plan. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Santa Clara Family Health Plan
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Santa Clara Family Health Plan volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 24077 — Direct-to-SCFHP claims, not all delegated network claims. |
| 270 / 271 eligibility | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Santa Clara Family Health Plan. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
portal_url
Source comparison: 2026-09-26
Official provider navigation links providerportal.scfhp.com.
Primary source for portal_urlprovider_phone
Source comparison: 2026-09-26
The provider/claims resource lists 408-874-1788.
Primary source for provider_phonepayer_ids.claims
Source comparison: 2026-09-26
24077 is for direct SCFHP claims through contracted clearinghouses. Medi-Cal delegated arrangements require separate routing.
Primary source for payer_ids.claimselectronic_claims_supported
Source comparison: 2026-09-26
Direct claims use 837 professional/institutional formats; paper is a stated exception when electronic submission is unavailable.
Primary source for electronic_claims_supportedtimely_filing_days
Source comparison: 2026-09-26
The source says one year from service; secondary claims use one year from the primary payer EOB. Preserve the calendar-year wording rather than treating every case as a uniform 365-day clock.
Primary source for timely_filing_days
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids.eligibility / payer_ids.era / era_payer_id / supports_278: The claim identifier and online remittance enrollment do not establish eligibility/ERA IDs or X12 278 capability..
Sources used for this guide
State coverage
Santa Clara Family Health Plan operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Santa Clara Family Health Plan
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Santa Clara Family Health Plan; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Santa Clara Family Health Plan; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Santa Clara Family Health Plan before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Santa Clara Family Health Plan
Where is the Santa Clara Family Health Plan provider portal?
Use https://providerportal.scfhp.com/ as a starting point for Santa Clara Family Health Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Santa Clara Family Health Plan?
For claims governed by the reviewed SCFHP instructions, file within one year from service; secondary claims use one year from the primary payer EOB. Preserve calendar-year wording and confirm delegated contracts.
Does Santa Clara Family Health Plan publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Santa Clara Family Health Plan. Claims: 24077 — Direct-to-SCFHP claims, not all delegated network claims.. Eligibility (270/271): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. ERA (835): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Santa Clara Family Health Plan. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment.. Do not substitute a claims ID for an unverified transaction ID. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Santa Clara Family Health Plan accept electronic claims?
Verify Santa Clara Family Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Santa Clara Family Health Plan denial?
This registry has not established a payer-specific appeal ladder for Santa Clara Family Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Santa Clara Family Health Plan prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Santa Clara Family Health Plan provider phone number?
This registry lists 1-408-874-1788 as a contact reference for Santa Clara Family Health Plan. The provider/claims resource lists 408-874-1788.
Automate workflows around Santa Clara Family Health Plan requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Santa Clara Family Health Plan's current published documents before submission. CPT® is a registered trademark of the American Medical Association.