Members & Visitors

For Members & Visitors

We are committed to providing you care with a purpose for you and your family. You are a sophisticated consumer who wants a provider that is passionate about your care and takes the time to get to know you and manage your healthcare and overall well-being. You are more than a medical record number at SCCIPA – you are a person and your health journey is unique to you.

One of the biggest advantages of finding a primary care provider through SCCIPA’s physician network is that they have connections with the wide range of medical specialists in our system. Medical care is more seamless and convenient when all of your providers can easily access your medical records, insurance information, and each other.

These links can tell you more about member and visitor services at SCCIPA:

SCCIPA Utilization Management

Criteria for our decision making processes are available to our members and providers upon request. If you would like to obtain a copy of the criteria used on the decision on one of your cases or if you need any other information regarding a request, please contact our customer service at 1-800-977-7478. This also pertains to out-of-area callers.

NCQA Required Adherence to Utilization Incentive Programs

In accordance with the requirements of National Committee for Quality Assurance (NCQA), SCCIPA Maintains Proper Utilization Incentive Programs:

  1. SCCIPA’s Utilization Management program description, policies, and practitioner contracts do not contain language with improper utilization incentive programs.
  2. Terms under which a SCCIPA practitioner may be entitled to a bonus or incentive pay do not influence a practitioner’s decision to withhold, delay, or deny necessary service.
  3. SCCIPA’s utilization management decision making is based only on appropriateness of care and service, and existence of coverage.
  4. SCCIPA does not specifically reward practitioners or other individuals for issuing denials of coverage or service care.
  5. SCCIPA does not offer financial incentives to utilization management decision makers that encourage decisions that result in underutilization.
  6. SCCIPA practitioners are ensured independence and impartiality in making referral decisions that will not influence hiring, compensation, termination, promotion, or any other similar matters.

For more information, call us at (800) 977-7332, or dial 711 for TTY. We can tell you more about our network and help you find a healthcare provider near you.