If you do not have a Sharp Account yet, you can submit a completed authorization form to request access. 1-562-308-3699 fax Awards and recognition are subject to change each year. To set up a hospital payment plan for a family member, call us at 858-499-2400. * Every year, Medicare evaluates plans based on a 5-star rating system. 1-800-837-0959 fax, Network Management To pay by credit card over the phone, please call Patient Financial Services: Check, cashier's check, money order and major credits cards are accepted at all Sharp HealthCare hospital and clinic locations. Read the full disclaimer. Cookies must be enabled to properly use this website. MORE OPTIONS + Brokers We're here to help you succeed. Credentialing: The physician's bill will be for the professional services. Please do not use this form to convey personal or medical information. Enjoy direct access to Sharp HealthCare and The Sharp Experience.*. You can choose how you want to receive your billing statements and notifications via mail, email or both. For your protection, we don't recommend using email to send personal medical information. Contact Sharp Health Plan to get answers on anything from paying a bill to signing up for coverage. MORE OPTIONS + Brokers We're here to help you succeed. Please clearly state State Fair Hearing Request on your correspondence. and Nov. 30, 2023. Were your neighbors, so you can count on us to be accessible. Contact Express Scripts for Part D Coverage Reviews Coverage Determinations 1-844-424-8886 (TTY: 1-800-716-3231) tel. doctor, hospital or urgent care, Inflation Reduction Act and Sharp Health Plan, City of San Diego employees & retirees (SDPEBA), 7 questions about the COVID-19 vaccine for kids, The young adults guide to accessing care, Get the most out of your pharmacy benefits, Safe disposal of prescription medications, Medicare and other insurance coverage questionnaire, Access to a loved ones health information, 4 ways to help employees prepare for open enrollment, Covered California expands financial help, Counseling patients to self-isolate at time of testing, Grace periods for delinquent payments by members, Mental health & substance use disorder services. Nu qu v, hay ngi m qu v ang gip , c cu hi v Sharp Health Plan, qu v s c quyn c gip v c thm thng tin bng ngn ng ca mnh Write: SCAN Claims Department P.O. Contracted providers can find reimbursement information in their Mercy Care contracts. 3800 Kilroy Airport Way, Suite 100 Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. 700+ Doctors More than 800 primary and specialty care physicians providing exceptional care and quality health services. email us at provider.relations@sharp.comor call 1-858-499-8330. Claims and EDI 1-877-778-7226. Toll-free 1-855-562-8853 TTY/TDD: 711 Our offices are closed on the following holidays in 2023: Email us You can send us an email at customer.service@sharp.com and we will get back to you. 1-877-251-5896 fax Home Delivery from Express Scripts Pharmacy . Write: Although physicians are licensed to practice at Sharp's hospitals, they are not Sharp HealthCare employees. If youre currently not a member and are interested in learning more about SCAN Health Plan, speak to one of our representatives by calling 1-877-452-5898. Complete ALL required fields, and include additional documentation when necessary. As reported in Medicare & You 2023 member rating of plan. Learn More. Learn how , These two screening tests can help prevent cervical cancer or detect it early. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. Contact your software vendor directly for questions about your electronic billing. Member Services Phone Number. You have entered a ZIP code that is not currently accepting enrollments. Address. 1-844-424-8886 (TTY: 1-800-716-3231) tel. If you do not pay the entire amount or contact the billing office to arrange a payment plan, your account will be sent to a collection agency. Many surgery and procedure names sound similar. For questions about this process, contact UPMC Health Plan Web Services at 1-800-937-0438 from 8 a.m. to 4:30 p.m., Monday through Friday. You can use Medicares 5-star special enrollment period to switch from your current Medicare plan to a Medicare plan with a 5-star quality rating. DentaQuest administers dental benefits for Mercy Care and Mercy Care Advantage. Contact us Coronavirus & COVID-19 resources for providers If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. checklist. For the best experience on our website, please upgrade your browser to the latest version. Thank you for making us the highest member-rated health plan in California for the eighth The request for State Fair Hearing must be filed in writing no later than 30 days after receipt of the Notice of Decision. Hours may change during holidays. The website information you will be accessing is provided by another organization or vendor. Stay up-to-date on Sharp Health Plan-related information related to coronavirus and COVID-19. min ph. 400, Wittman Drive Grand Rapids Itasca County MN - 55744 United . Your bill will list the services you received under the "Summary of Patient Services." Preferred Qualifications. P.O. , Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. Electronic billing ensures faster processing and payment of claims, eliminates the cost of sending paper claims, allows tracking of each claim sent and minimizes clerical data entry errors. am, Monday through Friday, and 24 hours a day on weekends. 1-888-327-9791 tel. Please read our. Please read our. Home Delivery from Express Scripts PharmacySM 1-877-863-3362 Sharp Health Plan , 1-800-359-2002. Following your medical procedure, our billing office files a claim with your primary health insurance for the services performed. Can't find your answer below? Sharp Health Plan is an HMO with a Medicare contract. By clicking on this link you will be leaving the SCAN webpage and will be directed to the CMS Electronic Complaint Form. Long Beach, CA 90801-5616. H5386_2022 Medicare Website_Rev10 Page Last Updated: 1/03/2023 Kung ikaw, o ang iyong tinutulangan, ay may mga katanungan tungkol sa Sharp Health Plan, may karapatan ka na makakuha ng tulong at impormasyon sa iyong wika ng walang gastos. Sharp Health Plan . AHCCCSOnline Website Not only do we now have the ability to receive disputes by fax, but we can also respond back to our providers via fax, allowing you to receive faster decisions. Sharp Health Plan Performance Plus UnitedHealthcare SignatureValue Alliance and SignatureValue Harmony UnitedHealthcare Group Medicare Advantage and Medicare Advantage Edge Western Health Advantage HMO and MyCare Select Medicare HMO Blue Shield of California and Kaiser Permanente administer their own Pharmacy Benefits. If you are still concerned, you may contact The Joint Commission at 1-800-994-6610. be a great option. 1-858-499-8211 With our providers, patients and health plans working together, we can ensure the best possible outcome every time. Customer care representatives are available to assist you. Nu qu v, hay ngi m qu v ang gip , c cu hi v Sharp Health Plan, qu v s c quyn c gip v c thm thng tin bng ngn ng ca mnh Sharp Health Plan . Si usted, o alguien a quien usted est ayudando, tiene preguntas acerca de Sharp Health Plan, tiene derecho a obtener ayuda e informacin en su idioma sin costo alguno. UPMC Health Plan claims. Encounter Data Team Encounters_Operations@scanhealthplan.com. We're your neighbors, so you can count on us to be accessible. networkmgmt@scanhealthplan.com, Office Ally Clearinghouse Contact Us; Forgot Username; Forgot Password; Schedule a Demo (855) 757-6060 Think of us as your personal health care assistant. Box 2906Milwaukee, WI53201-2906. PracticeBridge. Click here. Learn how you can help your patients through the Shingrix shortage. We are currently experiencing issues with our provider and site search tools. Customer Service Information To find doctors who accept Sharp Health Plan - HMO and their office locations, and more go to http://www.sharphealthplan.com/ Customer service phone number: 1-800-359-2002 Customer service TTY/TDD number: 711 (state relay service) Customer service hours/availability: 8:00am-6:00pm M-F SCAN also contracts with the California Department of Health Care Services for Medicare/Medi-Cal eligible beneficiaries. Thats why were committed to you. 1-800-600-4441. Please visit the, Resources for Foster/Kinship/Adoptive Families, Accessing Behavioral Health Services in Schools, AHCCCS Whole Person Care Initiative (WPCI), Emergency Triage, Treat and Transport (ET3), Report Concerns About Quality of Care Received, ALTCS Electronic Member Change Request (EMCR), Quality Assessment and Performance Improvement Strategy, Pre-Admission Screening and Resident Review (PASRR), Demographics, Social Determinants and Outcomes, Tribal Court Procedures for Involuntary Commitment, Contracted Health Plan Audited Financial Statements, Monkeypox Virus and Vaccination Information, Federal Funding Accountability and Transparency Act, Digital Tool Box Deliverable Reports & Schedule, Digital Tool Box AHCCCS Policy & Procedures, Quarterly Meeting Minutes and Presentations, Agency Tribal Consultation Annual Reports, American Indian Health Program (AIHP) Change Request Form, American Indian Health Program (AIHP) ID Request Form, If you have an HEAplus account- go to "Options" and click on the "Request New ID Card" link or, A Community Assistor can assist you in requesting the replacement card through their Assistor dashboard. 200 San Diego, CA 92123-1450 Fax: (619) 740-8571 7. Don't hesitate to send us an email or call us Monday through Friday, from 8 am to 4:30 pm: We know health care billing can seem complicated - so we work hard to ensure your experience with Sharp is straightforward and accurate. The claim dispute process should only be used after other attempts to resolve the matter have failed. Please contact Member Services. Click on the link for answers about Medicare Advantage and coverage. Health (3 days ago) Web101 Wood Avenue South, 8th Floor. Sharp Health Plan | Login Sign in Email address Password Forgot your password? This means the hospital and each of your treating physicians will send you a bill for their parts of your care. Mail-Order Or visit: https://dentaquest.com/state-plans/regions/arizona/, Mercy Care FinanceP.O. Fee-for-Service Fee Schedules, Contact Us Your most common questions, answered without playing phone tag. Hours may change during holidays. Find your health plan's address (PDF). Every year, Medicare evaluates plans based on a 5-star rating system. You can also search for your primary care doctor to find the medical group you and your doctor belong to. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time We could not identify your account with email address alone, please enter your first and last name to retrieve your security question. Explore SCAN plans available in your area! Get helpful reminders about how to comply with the timely access laws, which outline maximum wait times for phone calls and appointment requests. In the event the claim requires resubmission, health care providers have 180 days from , Health (6 days ago) WebContact Sharp Health Plan to learn about our plans or ask questions about your current coverage. Click below to learn more about which plans, benefits and doctors are available in your area. b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services. Many surgery and procedure names sound similar. AHCCCS (Arizona Health Care Cost Containment System) is Arizonas Medicaid Managed Care Program. Find a To learn more about our community programs and how these may work for your organization or event, call 1-877-806-7226 or email us. FL 22: Resubmission Code field must be billed with a "7" and the Original Reference Number field . Electronic submission*: Through Electronic Clearing House, DentaQuest of Arizona, LLC ClaimsP.O. Messages received on holidays and outside of our business hours will be returned within one business day. Your password has been reset. Don't want to pick up the phone? See if your doctor is covered under Sharp Direct Advantage Medicare plans. To include supporting documentation, such as members medical records, clearly label and send to the Claims Department at the correct address. With our providers, patients and health plan working together, we can ensure the best possible outcome every time. For eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, email us at provider.relations@sharp.com or call 1-858-499-8330. Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. If you believe that your needs have not been met, please use the above numbers to contact the hospital where the services were performed and ask to speak to a patient representative. Call 1-800-827-4277 or view our detailed phone directory. Box 982975 El Paso, TX 79998-2975. H.S. 1-855-562-8853 (TTY/TDD: 711) 7 am to 8 pm Pacific Time Due to COVID-19 restrictions, the Sharp Health Plan office is not open to visitors at this time. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time For more contact information, please click hereto access the Provider Operations Manual. If you have questions about your covered services, copays or deductibles - or which providers are in-network or out-of-network in your insurance plan - please call your health insurance company to confirm your coverage. If you have questions that include personal details, like your medical history, please call your doctor directly. Oct. 1 March 31, 8 a.m. 8 p.m., seven days a week, Write: If you opt for paperless billing, you may continue to receive paper bills for some services for yourself or loved ones. Quality care depends on clear communication between you and your patients. Enrollment in SCAN Health Plan depends on contract renewal. To see an example of a bill like yours, with descriptions for each section, please review our sample bill. b) Through the mail to the appropriate address: Additional information regarding claim submissions can be found in theProvider Manual. You can also use Sharp Account to view itemized bills, check your current balance and view your payment history. Visit your health plan's website to learn how benefits, claims, and payment of claims are covered, as well as the service limitations and exclusions that may apply. For member-specific information or questions: Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. With our cost-saving benefits, you could put more money back into your monthly budget. Request a price estimate to learn more about charges for services at a Sharp hospital or Sharp Rees-Stealy location. We are currently experiencing issues with our provider and site search tools. We are available 7 am to 8 pm, seven days a week. All of the points of contact are professional, committed and passionate about providing high-quality service. Don't want to pick up the phone? The General Data Protection Regulation (GDPR) governs the processing of personal information gathered from individuals while they are in the European Union (EU) and parts of the EEA (European Economic Area, which currently includes Iceland, Lichtenstein and Norway). You can also log in to myCalPERS to use the Search Health Plans tool to research the health plan coverage and benefits most important to you and your family. MORE OPTIONS + Plans purchased through Covered California If you purchased your plan directly from Covered California , Sharphealthplan.com To call a medical group office or department: Sharp Rees-Stealy: Department phone directory Sharp Community: 858-499-2550 SharpCare: 619-522-4000 Other contact information: Billing A provider may file a claim dispute based on: Before a provider initiates a claims dispute, the following needs to occur: o Within 12 months after the date of service. It's National Drug & Alcohol Facts Week. All electronic submissions shall be submitted in compliance with applicable law including HIPAA regulations and Mercy Care policies and procedures. Real Time Claim Status (RTS): NO. Box 22698 Long Beach, CA 90801-5616. Get better Medicare from San Diegos only 5-star plan with direct access to Sharp HealthCare. Search Sharp Health Plan PayerID SHP01 and find the complete info about Sharp Health Plan Insurance Type, LOB, ENR, RTE, RTS, ERA, SEC, Customer Service Number and more . Privacy Policy| Terms of Use| Nondiscrimination and Accessibility Requirements. Get free, confidential 24/7 treatment referral and information from the National Helpline. 1 Practice Locations Offering you and your family convenient access to care where you work, live and play. Your password has been reset. You can also search for your primary care doctor to find the medical group you and your doctor belong to. Hours are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. Mercy Care Claims Department P. O. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. After your claim is processed by your primary health insurance plan, our billing office will file claims with any secondary or supplemental insurance organizations that you have provided to us. Call our Customer Care team at (855) 995-5004 or submit a form. 1-888-705-7226 For general questions or provider portal registration, contact our Provider Account Management team. You may submit your claim dispute in writing through the mail or send electronically to us through fax. Claims Mailing Address: Medical. Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. Box 22698 General office experience, preferably in a service oriented environment. Instructions on how to fill out the claim forms can be found at the following AHCCCS website addresses: Submit original copies of claims electronically or through the mail (do NOT fax). Refer to our Provider Manual for more detailed information. To make changes to your payment plan, such as changing your payment method or making an extra payment, call us at 858-499-2400. Sharp Health Plan . The only way to ensure you have the full Sharp Experience, from coverage to care, is with a Sharp Direct Advantage plan - only from Sharp Health Plan. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. For example, if your deductible has been met and your coinsurance is 20 percent, your plan will cover the remaining 80 percent of covered services. Typically, you will pay your percentage of costs until you reach your plan's annual out-of-pocket maximum. You may also mail your payment to the address listed on your statement. [SBM Sharp Health Plan [ 1-800-359-2002. Health Insurance for Children, Provider Enrollment For Providers. You can pay by credit or debit card or by check. We are working to resolve this as quickly as possible. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. Follow the prompts to set your billing preferences. Sharp Health Plan is an HMO with a Medicare contract. Select the appropriate claim form (refer to table below): Hospital inpatient, outpatient, skilled nursing and emergency room services, Dental services that are considered medical services (oral surgery, anesthesiology), Mercy Care Claims DepartmentP. O. Sharp Direct Advantage is offered by Sharp Health Plan. Claims denied for timely filing must have an explanation for the delay as well as specific documentation. For questions about plans and benefits, members should call: April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday Check your coverage documents through Sharp Connect. To provide a more personalized experience, please select a state where SCAN is offered. 1-800-454-3730. For example, if you had an emergency room visit that required X-rays and lab tests, you may receive a bill from the hospital for technical resources, a bill from the emergency room physician for professional services, a bill from the radiologist for interpreting your X-rays and a bill from the pathologist for analyzing specimens from your lab tests.