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Non-contracted providers appealing DualConnect claim denials (not payment disputes) send the appeal with a Waiver of Liability statement. Contracted-provider and payment disputes use the online dispute form.

SCFHP DualConnect Part D coverage determinations and exceptions are handled by MedImpact; fax the Medicare Part D Coverage Determination Request Form. Medi-Cal pharmacy benefits are covered by Medi-Cal Rx, not SCFHP.

SCFHP prefers electronic claims through Change Healthcare or Office Ally using payer ID 24077; paper claims go to this address. Claims and provider disputes are NOT accepted by fax. Delegated Medi-Cal claims for NEMS, Optum Care Network, Conifer or Valley Health Plan groups go to those entities. Timely filing: one year from date of service.

Provider email help desks for utilization management and long-term services and supports questions, including CBAS emergency remote services.

Fax the SCFHP prior authorization request form with clinical documentation for SCFHP-managed Medi-Cal and DualConnect members. Members delegated to NEMS, Valley Health Plan or Premier Care of Northern California go to that group instead.

Referral/authorization center for outside providers referring contracted-health-plan patients to SCVMC outpatient specialty services; submit the referral form or EpicCare Link request.

Burn Center admissions, transfers and outpatient evaluation; ask for the charge nurse. The outpatient referral form is faxed to the same fax as the Authorization Center.

SCVMC Release of Information: signed Request for Release of Medical Record Information by fax (Attn: Release of Information), email, mail or in person; questions by phone. Records requested for a physician are sent at no cost.

SCVMC Medical Staff Office for provider questions about referrals and medical staff matters; only an email is published.

Neonatal intensive care unit admissions; ask for the attending physician.

Wound care referrals/authorizations at O'Connor Hospital.

County of Santa Clara Health System Patient Financial Services: HAP free/discounted care applications, help applying for Medi-Cal/Covered California, policy copies and language assistance. Fax, email or deliver completed applications with proof of identity and income.

Pediatric department admissions; ask for the attending physician.

Pediatric intensive care unit admissions; ask for the attending physician.

Radiology films and imaging CD requests (first CD free).

Referrals to the SCVMC Rehabilitation Center.

Wound care referrals/authorizations at St. Louise Regional Hospital.

Department phone published by the Arizona Department of Health Services. Program availability and tribal service arrangements require confirmation with the department.

Published in the California Department of Public Health immunization-program directory. Confirm the requested vaccine, service, appointment and jurisdiction with the office. This source does not establish general billing or insurance-plan support.

Published in the California Department of Public Health immunization-program directory. Confirm the requested vaccine, service, appointment and jurisdiction with the office. This source does not establish general billing or insurance-plan support.

Current linked Operations PDF, pages 18–19. Page 19 was visually reviewed. The same document retains older specialty-drug policies, which are not imported as current benefit rules. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Operations pages 23–24 distinguish provider disputes from original claims. Page 24 fax/address visually reviewed. The current document also offers the QuickCap PDR module. Filing deadlines must be checked against the applicable notice. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Resources-at-a-Glance, page 13, visually reviewed. The fax/phone are published for Credentialing and also appear under Quality Management; request the credentialing team. The linked manual is current on the site but does not establish a fresh publication date. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Current Reference & Support PDF, page 4, visually reviewed. This guide directs eligibility information to the health plan. No historic Medi-Cal phone or benefit determination is inferred. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Reference & Support PDF page 4 was visually reviewed. This is the explicitly labeled authorization inquiry route; older specialty-policy UM numbers are not substituted. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Operations page 1 and the current homepage corroborate portal support. The portal supports claims, authorizations and PDR; no account was entered. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Billing inquiries or concerns for Sarasota Memorial bills; toll-free (800) 764-2455 also listed. The page also lists separate numbers for independent physician groups and other billers that are not Sarasota Memorial.

Questions from community providers about EpicCare Link access status and onboarding, coordinated by Sarasota Memorial (not the Sarasota Medical Society).

Care providers fax release-of-information requests on facility letterhead with patient name, date of birth, date of visit and treating facility. The phone is published for after-hours, urgent provider requests. Subpoenas go to the Subpoena Intake Office (941-917-1328).

Patient copies of medical records (excluding radiology images). In-person ROI offices: SMH-Sarasota Campus (1515 S. Osprey Ave., Building D), SMH Toledo Blade Emergency Care Center (North Port) and SMH-Venice Campus. Care providers use the separate continuity-of-care fax line.

Practitioners request hospital credentialing / privileges applications by email (Medical Staff Services). Medical staff bylaws and policies are on the same page. Not payer credentialing.

Help with the financial assistance application; leave a message with name and phone and a team member returns the call within 48 hours. Patients must contact the team within 180 days of admission per the page.

Written personalized estimates for scheduled services at Sarasota Memorial. Not a payer eligibility line.

Send radiology records/image request documents by email or fax, per the records request page.

SMH accepts subpoenas only by hand service or certified mail. Phone is for questions about subpoena delivery. Other attorney record requests (not subpoenas) go to the Sarasota Campus, Attention Pine Tree Plaza, Bldg. D.

One call to the Transfer Center initiates a transfer to Sarasota Memorial. Physicians without access to the SMH EHR fax the patient chart and diagnostics to the listed fax or send them with the patient.

Request a written personalized estimate for scheduled services. The Price Quote Line phone is listed separately on this record.

NYSDOH lists this local health department number for communicable disease questions. Phone table revised March 2026.

Patient education contact published by the ELEVIDYS support page. This mailbox is not the SareptAssist enrollment submission email.

Sarepta contact page: Healthcare Providers — Medical Information at the SareptAssist number, option 2. Use the published option for medical questions rather than enrollment/reimbursement.

Both currently linked forms permit authorization cancellation by fax or letter. Neither withdrawal paragraph specifies the enrollment email as a revocation method.

Use the August 2026 gene-therapy form and its required genetic report, insurance and consent documents. Printed form-page numbers differ from PDF-page numbers. The form also routes companion-diagnostic kit and home-phlebotomy questions through SareptAssist; specimen collection follows its separate instructions.

Current SareptAssist page links the November 2023 exon-skipping enrollment form. Use the applicable exon and current prescriber information; the URL folder date is older than the printed form date. Financial assistance requires program review; independent charities remain separate.

Administration contact in North Dakota HHS directory, updated March 2026. Seven-digit directory numbers are normalized with North Dakota area code 701. Named staff email addresses are omitted. Individual program and tribal jurisdiction limits may apply.

Published department branch office using the department main phone. The county district listing describes the department referral area; individual office services require confirmation.

Published department website contact information, checked October 22, 2026; county district boundaries are supported by the September 4, 2026 Nebraska DHHS map.

State agency/health-officer directory contact. The source does not promise a general switchboard, appointment eligibility or a response time. Personal staff email omitted.