Credentialing: UPMC Health Plan claims. P.O. SCAN Health Plan is an HMO plan 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. Thank you for making us the highest member-rated health plan in California for the eighth Many surgery and procedure names sound similar. We offer high-quality, affordable health insurance for San Diegans of all ages with 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. Please do not use this form to convey personal or medical information. and Nov. 30, 2023. Call 1-800-827-4277 or view our detailed phone directory. Please print and use this permission to discuss protected health information form to allow someone to speak toSharp Rees-Stealy representativesregarding your billing information. Please see the below for more contact options. Please contact Member Services. 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. Phone: 1-858-499-8200. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time o Or within 60 days after the date of the denial of a timely claim submission, whichever is later. There are three ways for AHCCCS members to change their AHCCCS enrollment: If you need to request an ID card replacement there are four options: Phone: 602-417-4000 Electronic submission*: Through Electronic Clearing House SharpCare Medical Group patients can use this form to make online payments. 8 a.m. to 8 p.m., Monday Friday, from April 1 to September 30. Oct. 1 March 31, 8 a.m. 8 p.m., seven days a week, Write: Read up on ways to protect your colorectal health. We provide dedicated bilingual (English/Spanish) representatives to our members and free over-the-phone translation services in dozens of other languages. The monthly premium for our new VIP Plan is $0. Electronic prescribing mandate information. Financial assistance is available for qualified low-income patients to assist with all or part of a hospital bill. 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. 1-800-359-2002 . ) 1-800-359-2002. Although physicians are licensed to practice at Sharp's hospitals, they are not Sharp HealthCare employees. http://oig.hhs.gov/fraud/report-fraud/index.asp. Sharp health plan provider phone number, Health (2 days ago) WebFor eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, email us at [emailprotected] or call 1-858-499-8330. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. AHCCCS (Arizona Health Care Cost Containment System) is Arizonas Medicaid Managed Care Program. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. 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 You can send us an email at customer.service@sharp.com and we will get back toyou. Please refer to our Billing, Collections and Bad Debt policy. To see an example of a bill like yours, with descriptions for each section, please review our sample bill. SCAN Health Plan Contact Sharp Health Plan to get answers on anything from paying a bill to signing up for coverage. 1-800-454-3730. You can join today, right from your laptop or phone. direct access to Sharp HealthCare. CALL NOW. Please include all supporting documentation with the initial claim dispute submission. Get free, confidential 24/7 treatment referral and information from the National Helpline. If you have a health question or concern after regular business hours, you can talk to a nurse through our after-hours nurse line.Call Sharp Nurse Connection at 1-855-562-8853 from 5 pm to 8 Due to COVID-19 restrictions, the Sharp Health Plan office is not open to visitors at this time. These important numbers are located on your billing statement. Refer to your insurance card or call your insurance provider to determine your medical group. 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. Home Delivery from Express Scripts PharmacySM Our updated Mercy Care Claims Processing Manualis now available to assist you with any claims or billing questions you may have. 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. Please read our. You can also use Sharp Account to view itemized bills, check your current balance and view your payment history. Real Time Claim Status (RTS): NO. Electronic Remittance Advice (835) [ERA]: YES. Encounters_Operations@scanhealthplan.com, Contact Express Scripts for Part D Coverage Reviews Sharp is not-for-profit and relies on fundraising. Interested in joining the SCAN provider network? Sharp Direct Advantage is offered by Sharp Health Plan. If you still need answers, please send us an email or give us a call: It's not uncommon to receive statements or bills from more than one provider for one hospital visit. Follow the prompts to set your billing preferences. Messages received on holidays and outside of our business hours will be returned within one business day. 3800 Kilroy Airport Way, Suite 100 Manage your claims. We're here to help shed light on the bills you may receive. Learn about the basics of Medicare, how to enroll, andmore. Send us an email instead. *Star rating applies to all plans in California offered by SCAN Health Plan 2018-2023 except SCAN Healthy at Home (HMO SNP) and VillageHealth (HMO-POS SNP) plans. Enrollment in SCAN Health Plan depends on contract renewal. Para hablar con un intrprete, llame al 1-800-359-2002. Your password has been reset. To set up a hospital payment plan for a family member, call us at 858-499-2400. . Contact your software vendor directly for questions about your electronic billing. 1-877-7NYSHIP (1-877-769-7447), choose UnitedHealthcare . MORE OPTIONS + Plans purchased through Covered California If you purchased your plan directly from , Health (9 days ago) WebContact Sharp HealthCare To find a doctor or register for a class or event, call us at 1-800-827-4277. In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Encounter Data Team Encounters_Operations@scanhealthplan.com. Preferred Qualifications. Learn More. 1-855-562-8853 (TTY/TDD: 711) 7 am to 8 pm Pacific Time instructions from the Health Plan and the Department of Managed Health Care. If you choose to send via fax, please fax your disputes to 602 351-2300. These important numbers are located on your billing statement. Box 90640Phoenix, AZ 85066. We could not identify your account with email address alone, please enter your first and last name to retrieve your security question. Effective immediately, providers who are submitting paper corrected claims to Fidelis Care must follow the claim and field billing guidelines below. SHARP HEALTH PLAN - 16 Photos & 197 Reviews - Insurance - 8520 Tech Way, San Diego, CA - Phone Number - Yelp Sharp Health Plan 197 reviews Claimed Insurance Closed 8:00 AM - 5:00 PM Steve Lyons - State Farm Insurance Agent Rich Nye - State Farm Insurance Agent Frequently Asked Questions about Sharp Health Plan How is Sharp Health Plan rated? We offer high-quality, affordable health insurance for San Diegans of all ages with direct access to Sharp HealthCare. Claims denied for timely filing must have an explanation for the delay as well as specific documentation. Box 982975 El Paso, TX 79998-2975. Health (6 days ago) WebContact Us . Attn: Member Services We're your neighbors, so you can count on us to be accessible. Visit our FAQ and get your questions answered. Para hablar con un intrprete, llame al 1-800-359-2002. It's easy to register. Toll-free 1-855-562-8853 TTY/TDD: 711 Our , Health (9 days ago) WebSharp Health Plan. Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. Rated 4.5 out of 5 stars by Medicare six years in a row! refill on a road trip. This service is free of charge and also includes American Sign Language translators. , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services. Long Beach, CA 90806, EthicsPoint min ph. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Refer to your insurance card or call your insurance provider to determine your medical group. Quality care depends on clear communication between you and your patients. To set up a payment plan for a Sharp Rees-Stealy bill or to inquire about a payment plan for a family member's bill, call us at 858-499-2400. 1-877-251-5896 fax For general information or questions about quotes, rates or materials: At this time, the Sharp Health Plan office is not open to visitors due to coronavirus (COVID-19) restrictions. Hours may change during holidays. Please check the box proving that you are not a robot. Sharphealthplan.com Category: Health Detail Health Contact us - Phone numbers, email, mailing address Health (2 days ago) WebCall us at 1-858-499-8300. 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. 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. MORE OPTIONS + Brokers We're here to help you succeed. Your bill will list the services you received under the "Summary of Patient Services." Thank you for your understanding as we work to ensure everyone remains healthy and safe. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. FL 64: Document Control Number field must be billed with the Fidelis Care original claim number. am, Monday through Friday, and 24 hours a day on weekends. About the billing process Paying your bill Payment plans Understanding your bill Paying a family member's bills Consumer protections from surprise billing About the billing process. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. , Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. Every hospital visit involves both physician and hospital resources. Phone: 1-858-499-8330 Caregivers for SCAN Members can receive help with their login credentials here. MORE OPTIONS + Plans purchased through Covered California If you purchased your plan directly from Covered California , Sharphealthplan.com You can choose how you want to receive your billing statements and notifications via mail, email or both. Use your member ID number to sign For the best experience on our website, please upgrade your browser to the latest version. March is Colorectal Cancer Awareness Month. Sharp Health Plan is accepting enrollments all year, thanks to the 5-star special enrollment period. Go to www.sharphealthplan.com/payment to pay now. 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. You can also search for your primary care doctor to find the medical group you and your doctor belong to. Due to California privacy regulations, the information you can access for minor patients will depend on their age. Call 1-800-827-4277 or view our detailed phone directory. Address. 1-888-445-2038. It's National Drug & Alcohol Facts Week. See if your doctor is covered under Sharp Direct Advantage Medicare plans. Your password has been reset. You can call us Monday through Friday, 8 am to 5 pm. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. To select your communication preferences, including whether to have your plan materials mailed to you or sent electronically, register a member account. In addition, we have interpreters available for our members when needed and can arrange to have a translator meet members at their doctors appointments (Tambin tenemos intrpretes disponibles, si usted necesita uno). Many surgery and procedure names sound similar. Sharp Health Plan is an HMO with a Medicare contract. 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. We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. 1-800-359-2002. You will need to provide your personal information and the invoice or visit number from your paper statement for each payment. 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. , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . AHCCCS American Indian Health Program (AIHP) provides medically necessary services for enrolled members. AI/AN members can switch their enrollment between AHCCCS AIHP and an AHCCCS managed health care plan and back again at any time. Sharp is not-for-profit and relies on fundraising. Policy Manuals Contact us Coronavirus & COVID-19 , Health (2 days ago) WebCall us at 1-858-499-8300. 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. Voz y TTY (telfono de texto):1-800-855-3000. *Star rating applies to all plans in California offered by SCAN Health Plan 2018-2023 except SCAN Healthy at Home (HMO SNP) and VillageHealth (HMO-POS SNP) plans. 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. 1-888-327-9791 tel. 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. Sharp Health Plan . Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. You may submit your claim dispute in writing through the mail or send electronically to us through fax. As reported in Medicare & You 2023 member rating of plan. Visit Medicare to compare other plan ratings and find detailed reports. Hours may change during holidays. Sharp Health Plan 1.800.359.2002. Customer care representatives are available to assist you. Call our Customer Care team at (855) 995-5004 or submit a form. 1-877-863-3362 Subscribe to Newsletters We are available 7 am to 8 pm, seven days a week. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. Contact us. Seven days a week, Default (Select appropriate section in drop down menu to populate), Get the most out of your pharmacy benefits, Understanding your explanation of benefits, Medicares 5-star special enrollment period. For eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, please April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday 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. Medicare Crossover Have a computer with Internet access Can download and install a free Active-X secure FTP add-on. Enjoy direct access to Sharp HealthCare and The Sharp Experience.*. Upang makausap ang isang tagasalin, tumawag sa 1-800-359-2002. REDUCE RISK , Learn how to reduce colon cancer risk by making healthy lifestyle changes. If you cannot pay the entire amount, you can set up a payment plan via Sharp Account for qualifying or eligible hospital bills. Sharp Health Plan 1.800.359.2002. Long Beach, CA 90801-5616. This position provides support and assistance to the Claims Department. Thats why were committed to you. ni chuyn vi mt thng dch vin, xin gi 1-800-359-2002. Sharp Health Plan Payer ID: SHP01; Electronic Services Available (EDI) Professional/1500 Claims: YES: Institutional/UB Claims: YES: Electronic Remittance (ERA) YES: ERA Enrollment Required: This insurance is also known as: . Please check the box proving that you are not a robot. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. Enrollment with Sharp Health Plan depends on contract renewal. LEARN MORE . b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. Get better Medicare from San Diegos only 5-star plan with direct access to Sharp HealthCare. FBT: SharpHealthPlan.com no longer supports this Internet browser. Providers who are contracted with Mercy Care can use electronic billing software. In many cases, payment is sent directly to us from your health insurance provider. [SBM Sharp Health Plan [ 1-800-359-2002. Although the hospital and the physician may use the same language to describe each charge, their bills are for separate services. Required Qualifications. Get the right support so that no questions are left unanswered. Pay Your Premium Members Brokers Providers Employers Members Talk to a real person. Yog koj xav nrog ib tug neeg txhais lus tham, hu rau 1-800-359-2002. Find your health plan's address (PDF). Find a Send us an email instead. Hours may change during holidays see below. Health (1 days ago) WebSharp Health Plan Login Sign in Email address Password Forgot your password? Interfaces with other Sharp Health Plan employees to provide information as requested for other Departments. 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). 1-562-308-3699 fax MORE OPTIONS + Brokers If you opt for paperless billing, you may continue to receive paper bills for some services for yourself or loved ones. Enrollment with Sharp Health Plan depends on contract renewal. 562-508-6781 With our providers, patients and health plan working together, we can ensure the best possible outcome every time. Sharp Health Plan , 1-800-359-2002. For questions about plans and benefits, members should call: April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday You may also mail your payment to the address listed on your statement. As the parent or guardian of a child aged 12 to 17, you cannot view billing information (including balances, statements and payment history) or other related items. 400, Wittman Drive Grand Rapids Itasca County MN - 55744 United . 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. Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. Mercy Care Claims Department P. O. Email your SCAN Network Management representative. Hours are 8 a.m. to 8 p.m. from April 1 to Sept. 30, Monday through Friday. Sharp HealthCare will make every effort to ensure the information contained in this guide is accurate and current. Contact Sharp HealthCare To find a doctor or register for a class or event, call us at 1-800-827-4277. Seffrah Orlando, Senior Public Relations Specialist The SCAN Sales Support team works with brokers and broker agencies to answer questions regarding plan benefits, eligibility, enrollment, network, formulary and other issues. Effective January 1, 2022, all California health care practitioners who are authorized to prescribe will be required to issue prescriptions electronically. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. Seven days a week, Get the most out of your pharmacy benefits, Understanding your explanation of benefits. Contact Us; Forgot Username; Forgot Password; Schedule a Demo (855) 757-6060 Box 22698 To get started, sign in to your Sharp Account and select "Paperless Billing" from the menu options. You should only sign this section if you want to cancel this authorization. Box 22698 Long Beach, CA 90801-5616. The request for State Fair Hearing must be filed in writing no later than 30 days after receipt of the Notice of Decision. For general information or questions about quotes, rates or materials: Write: SCAN Claims Department P.O. Box 982975El Paso, TX 79998-2975. Get helpful reminders about how to comply with the timely access laws, which outline maximum wait times for phone calls and appointment requests. Looking for Provider Login or Agent/Broker Login? Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. We are making improvements to how you can view and pay your bills through your Sharp Account. 1-800-HHS-TIPS (1-800-447-8477) For general information or questions about quotes, rates or materials: Member Services Phone Number. Sharp Health Plan , 1-800-359-2002. . Caregivers for SCAN Members can receive help with their login credentials here. SCAN also contracts with the California Department of Health Care Services for Medicare/Medi-Cal eligible beneficiaries. If you are still concerned, you may contact The Joint Commission at 1-800-994-6610. Your insurance plan also mails you an EOB, which details how they processed our bill and calculated your responsibility based on your individual insurance plan. Eligibility, referrals, or claims: www.ethicspoint.com, SCAN SIU Team If you do not want to leave our website, please click the X. You can use this special enrollment period only once between Dec. 8, 2022, 8 a.m. to 8 p.m., Seven days a week, from October 1 to March 31. ", - Sherri R., Director of Benefits & HR Information Systems, Palomar Health. Sharp Health Plan . It is important to note that balance billing members is prohibited under all Mercy Care health plans. Fee-for-Service Fee Schedules, Contact Us Shop plans 1 2 3 4 5 6 Enroll online Talk to a , Health (8 days ago) WebThe original claim must be received by The Health Plan 180 days from the date of service.