Santa Clara Family Health Plan (SCFHP) can provide dental care in certain cases. These may include topical fluoride varnish for members under 7 years of age, medications prescribed by a dentist based on medical needs, dental services for radiation treatment, and dental anesthesia. Prior authorization may be required. The SCFHP Medi-Cal plan also covers emergency services in the United States and its territories.
If the non-plan provider is not willing to continue providing services, does not agree on payment or other terms to provide care, then you will not be able to receive ongoing care from the provider. However, for pregnancy testing, family planning services, birth control, or sexually transmitted infection services, the doctor or clinic does not have to be part of the SCFHP network. You can find more information in your Medi-Cal Member Handbook. Tomcala works in collaboration with the SCFHP Governing Board to develop and execute business, strategic and financial plans that promote the mission and values of the health plan while ensuring the integrity and financial viability of SCFHP.
We try to make it as easy as possible for you to keep your coverage and file your redetermination forms every year. If you are a new member of SCFHP Medi-Cal, you will receive a medical information form (HIF) in the mail with your welcome pack. You should also call the Social Services Agency and the Santa Clara County Social Security Administration to change your address. You can print the SHA form in your preferred language on the Department of Health Care Services website.
The SHA is a set of questions that allow the doctor to understand your health and help you decide what types of services you need. When HCO receives your call or form, HCO will send you a letter within 15 to 45 days informing you that the health plan change has been made. The provider bills Medi-Cal for services through an entity known as a tax intermediary, which has a contract with the California Department of Health Care Services (DHCS) to process Medi-Cal claims and issue refunds. Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to creating opportunities for better health and well-being for all. If you do, your Palo Alto Medical Foundation coverage will begin on the first day of the following month.
