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Scott & White Health Plan doesn’t require members to select a primary care physician (PCP). You have the flexibility of using any of our network providers. However, if you choose to select a PCP, you can. In fact, everyone on your plan can select their own PCP.

All claims are processed at the Scott & White Health Plan headquarters in Temple, Texas. When a Scott & White Health Plan member is covered by more than one insurance or medical plan, we coordinate benefits paid by SWHP to avoid duplicate coverage and payment. A copy of the other insurance Explanation of Benefits (EOB) must accompany any claims submitted to Scott & White Health Plan for secondary coverage determination.

Subrogation

Subrogation refers to cases when another person or insurance company is responsible for payment of medical services. Injuries on someone else’s premises and motor vehicle accidents are the most common examples. Scott & White Health Plan expects to be reimbursed for expenses paid for care if a third party is responsible.

Bratton Firm acts as our representative in subrogation claims. If Scott & White Health Plan has already paid medical expenses, Bratton Firm will investigate. For questions regarding possible subrogation claims, please contact Bratton Firm at 1-800-741-4926.

Workers Compensation

Injuries related to on-the-job circumstances should be filed directly with the Workers Compensation carrier or the employer involved. Scott & White Health Plan does not pay for work-related injuries.

More Claims Information

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For questions related to claims issues, including claims submissions, payments, denials and adjustments, call us at 1-800-321-7947 and ask for the claims department.