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, Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. SCAN also contracts with the California Department of Health Care Services for Medicare/Medi-Cal eligible beneficiaries. For Providers. If you are experiencing a medical emergency, call 911 or visit the nearest emergency room. The amount you are charged is the portion of your bill your insurance policy does not cover - it is based on what your insurance plan communicates to us on your explanation of benefits (EOB). We are currently experiencing issues with our provider and site search tools. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. However, making a partial payment will not prevent a past-due bill from going to a collections agency. email us at provider.relations@sharp.com or call1-858-499-8330. min ph. Click here and follow the instructions. b) Through the mail to the appropriate address: Additional information regarding claim submissions can be found in theProvider Manual. When you connect to a loved one's Sharp Account, you can: To manage the care of a dependent adult, such as a parent, you will need to provide proof of conservatorship, power of attorney or an advance directive. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. Call our Customer Care team at (855) 995-5004 or submit a form. 2023SCAN Health Plan. Your password has been reset. Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. You may submit your claim dispute in writing through the mail or send electronically to us through fax. Messages received on holidays and outside of our business hours will be returned within one business day. Mercy Care is contracted with AHCCCS to provide Medicaid covered benefits and services to Mercy Caremembers. We are available 7 am to 8 pm, seven days a week. You can call us Monday through Friday, 8 am to 5 pm. Contact Sharp Health Plan to get answers on anything from paying a bill to signing up for coverage. Due to COVID-19 restrictions, the Sharp Health Plan office is not open to visitors at this time. TTY/TDD users can dial 711 or use the California Relay Services toll-free phonenumbers. At this time, the Sharp Health Plan . The Health Plan encourages electronic claims submission . 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). checklist. Members Brokers Providers Employers Members Talk to a real person. If you are experiencing a medical emergency, call 911 or visit the nearest emergency room. Contact us. For any claims, eligibility, or referral inquiries, contact our dedicated Customer Care team. You may receive a bill from us after your health insurance plan processes our bill. Claims Processor at Sharp HealthCare in San Diego Claims Processor Job ID JR133620 Date Posted 01/25/2023 San Diego, California Corporate Offices Day Regular Apply now Responsibilities Hours Shift Start Time: Variable Shift End Time: Variable Additional Shift Information: between 05:00 am - 09:00 am Weekend Requirements: As Needed On-Call Required: MC will acknowledge a claim dispute request within five (5) business days after receipt. You can call us Monday to Friday, 8 am to 6 pm. The provider should contact MC Claims and/or Network Management to seek additional information prior to initiating a claim dispute. You can call us Monday through Friday, 8 am to 6 pm. Our fax number is 1-858-303-9049. SharpHealthPlan.com no longer supports this Internet browser. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. You can call us Monday through Friday, 8 am to 5 pm. For the best experience on our website, please upgrade your browser to the latest version. View past statements and payment history from the last 18 months, Save a payment method for quicker check out, Access patient portals and other digital tools. Cash is accepted at hospitals only. Provider Relations Phone Number. To have your name removed from our advertising mailing list, please complete and submit the Mailing List Removal form. Were here to help you help your patients. These important numbers are located on your billing statement. Thank you for your understanding as we work to ensure everyone remains healthy and safe. direct access to Sharp HealthCare. FL 22: Resubmission Code field must be billed with a "7" and the Original Reference Number field . TTY/TDD users can dial 711 or use the California Relay Services toll-free phone numbers. If you have questions that include personal details, like your medical history, please call your doctor directly. If you believe that the determination is not correct, you or your authorized representative has the right to appeal the decision by filing a grievance with your health plan. Messages received on holidays and outside of our business hours will be returned within one business day. You may also mail your payment to the address listed on your statement. b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. Enrollment in SCAN Health Plan depends on contract renewal. Please see the below for more contact options. REDUCE RISK , Learn how to reduce colon cancer risk by making healthy lifestyle changes. These hours may change during holidays see below. Complete testing with UPMC Health Plan. You can also search for your primary care doctor to find the medical group you and your doctor belong to. Call us at 858-627-5201, Monday to Friday, 6 am to 8 pm, so we may assist you. Write: a) Claims must be legible and suitable for imaging and/or microfilming for permanent record retention. You can talk to a nurse 5 pm to 8am, Monday to Friday, and 24 hours a day on weekends by calling 1-800-359-2002. . A claim dispute is a dispute involving the payment of a claim, denial of a claim, imposition of a sanction or reinsurance. Health (3 days ago) Web101 Wood Avenue South, 8th Floor. 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. 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. Get the right support so that no questions are left unanswered. Health Insurance for Children, Provider Enrollment 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. Box 2906Milwaukee, WI53201-2906. The monthly premium for our new VIP Plan is $0. Sharp HealthCare will make every effort to ensure the information contained in this guide is accurate and current. Click on the link for answers about Medicare Advantage and coverage. We could not identify your account with email address alone, please enter your first and last name to retrieve your security question. Claims denied for timely filing must have an explanation for the delay as well as specific documentation. Awards and recognition are subject to change each year. Home Delivery from Express Scripts PharmacySM Privacy Policy| Terms of Use| Nondiscrimination and Accessibility Requirements. and Nov. 30, 2023. 562-508-6781 Request a price estimate to learn more about charges for services at a Sharp hospital or Sharp Rees-Stealy location. To include supporting documentation, such as members medical records, clearly label and send to the Claims Department at the correct address. *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. Seffrah Orlando, Senior Public Relations Specialist Many surgery and procedure names sound similar. Policy Manuals Empire Plan Toll free. Enrollment with Sharp Health Plan depends on contract renewal. Contact Us; Forgot Username; Forgot Password; Schedule a Demo (855) 757-6060 If you use FollowMyHealth, you may grant account access to any adult. 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). 1-858-499-8211 Please check the box proving that you are not a robot. MC may request an extension of up to 45 days, if necessary. Call us We are available 7 am to 8 pm, seven days a week. Find out more , Stay informed. REVOCATION You may revoke this authorization at any time by signing and dating this section of the form and returning it to Sharp Health Plan. Enrollment with Sharp Health Plan depends on contract renewal. 1-888-445-2038. Providers who are contracted with Mercy Care can use electronic billing software. Contact Sharp HealthCare To find a doctor or register for a class or event, call us at 1-800-827-4277. Our fax number is 1-858-303-9049 . We're your neighbors, so you can count on us to be accessible. Messages received on holidays and outside of normal business hours will be returned within one business day. If you have questions regarding your claims for DentaQuest, you can contact them directly at 844-234-9831. Long Beach, CA 90806, EthicsPoint For more contact information, please click hereto access the Provider Operations Manual. For member-specific information or questions: For our members' protection, we don't recommend using email to send personal medical information. Click here to read the full disclaimer. Toll-free 1-855-562-8853 TTY/TDD: 711 Our , Health (9 days ago) WebSharp Health Plan. instructions from the Health Plan and the Department of Managed Health Care. Enjoy direct access to Sharp HealthCare and The Sharp Experience.*. AI/AN members can switch their enrollment between AHCCCS AIHP and an AHCCCS managed health care plan and back again at any time. Credentialing: LEARN MORE , Let our members know about screening tests to help prevent or detect cervical cancer. You can choose how you want to receive your billing statements and notifications via mail, email or both. Get helpful reminders about how to comply with the timely access laws, which outline maximum wait times for phone calls and appointment requests. All rights reserved. However, a member can change from one managed health care plan to another (for example, Mercy Care Plan to Molina Healthcare) only once a year. H5386_2022 Medicare Website_Rev10 Page Last Updated: 1/03/2023 Due to California privacy regulations, the information you can access for minor patients will depend on their age. Hours are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. Visit our FAQ and get your questions answered. Sharp Health Plan1-800-359-2002 . For general questions or provider portal registration, contact our Provider Account Management team. If a provider does not receive an acknowledgement letter within five (5) business days, the provider must contact the Appeals Department. Sharp Health Plan is an HMO with a Medicare contract. Thank you for making us the highest member-rated health plan in California for the eighth 1 Practice Locations Offering you and your family convenient access to care where you work, live and play. 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. P.O. 1-888-705-7226 GET INFO , Share this information with our members to help reduce their heart disease risk. Although physicians are licensed to practice at Sharp's hospitals, they are not Sharp HealthCare employees. Enrollment with Sharp Health Plan depends on contract renewal. TTY/TDD users: dial 711 or use the California Relay Services toll-free phone numbers. Ready for comprehensive Medicare Advantage coverage that could save you money? Make sure your contact information is up to date. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. Don't want to pick up the phone? DentaQuest administers dental benefits for Mercy Care and Mercy Care Advantage. 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. Click hereand follow the instructions. 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. 1-877-863-3362 Quality care depends on clear communication between you and your patients. 3800 Kilroy Airport Way, Suite 100 Please visit Sharp.com or call your provider. We are making improvements to how you can view and pay your bills through your Sharp Account. It's National Drug & Alcohol Facts Week. , , Sharp Health Plan, . Sharp Health Plan . Sharp Health Plan is an HMO with a Medicare contract. 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 Electronic Remittance Advice (835) [ERA]: YES. Contact Express Scripts for Part D Coverage Reviews Coverage Determinations 1-844-424-8886 (TTY: 1-800-716-3231) tel. MORE OPTIONS + Plans purchased through Covered California If you purchased your plan directly from Covered California , Sharphealthplan.com If you are still concerned, you may contact The Joint Commission at 1-800-994-6610. SCAN Health Plan is an HMO plan with a Medicare contract. 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. http://oig.hhs.gov/fraud/report-fraud/index.asp. Our offices are closed on the followingholidays in 2023: You can send us an email at customer.service@sharp.com and we will get back toyou. Seven days a week, Get the most out of your pharmacy benefits, Understanding your explanation of benefits. Diploma or Equivalent; Essential . If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor. For the best experience on our website, please upgrade your browser to the latest version. There is a problem with enrollment at this time. , , Sharp Health Plan, . Sharp Health Plan is accepting enrollments all year, thanks to the 5-star special enrollment period. We offer high-quality, affordable health insurance for San Diegans of all ages with Call us at 1-858-499-8300. To make changes to your payment plan, such as changing your payment method or making an extra payment, call us at 858-499-2400. For general information or questions about quotes, rates, or materials: For member-specific information or questions: Were here to help you help your patients. Dr. Alan Kadet's office New York, NY Check eligibility & benefits. Sharp Health Plan . 8 a.m. to 8 p.m., Monday Friday, from April 1 to September 30. 400, Wittman Drive Grand Rapids Itasca County MN - 55744 United . Please read our. Need Member Help Logging In? Please check the box proving that you are not a robot. Pay Your Premium With our providers, patients and health plan working together, we can ensure the best possible outcome every time. In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Claims Mailing Address: Medical. 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 Our billing office will make several attempts to collect payment. Provider Account Management: Recently completed plans and new plans may not display on the Hospital Payment Plans section within Sharp Account. 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. Hours may change during holidays. GET INFO , Half of Americans have at least one risk factor for heart disease. It is important to note that balance billing members is prohibited under all Mercy Care health plans. Now its our turn to serveyou. To provide a more personalized experience, please select a state where SCAN is offered. Arizona state law and your Mercy Care provider contract prohibits balance billing MC members for Medicaid covered services and benefits. , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . For general questions or provider portal registration, contact our Provider Account Management team. , Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. Sharp is not-for-profit and relies on fundraising. Long Beach, CA 90801-5616, Encounter Data Team The claim dispute must specifically state the factual and legal basis for the relief requested, along with copies of any supporting documentation, such as remittance advice(s), medical records or claims. If you choose to send via fax, please fax your disputes to 602 351-2300. Your bill will list the services you received under the "Summary of Patient Services." FraudWaste&AbuseProg@scanhealthplan.com, Office of Inspector General, U.S. Department of Health & Human Services. For the best experience on our website, please upgrade your browser to the latest version. Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. Talk to a real person. Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. 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 Hours may change during holidays. These important numbers are located on your billing statement. Contracted providers can find reimbursement information in their Mercy Care contracts. Interfaces with other Sharp Health Plan employees to provide information as requested for other Departments. Find a Eligibility, referrals, or claims: Hours are 8 a.m. to 8 p.m. from April 1 to Sept. 30, Monday through Friday. You can join today, right from your laptop or phone. If you would like to discuss your bill or payment options, please give us a call: To set up a payment plan for a hospital bill, sign in to your Sharp Account. Sharp Health Plan is an HMO with a Medicare contract. Write: Health (6 days ago) WebContact Us . Cookies must be enabled to properly use this website. 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. 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. 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. Effective January 1, 2022, all California health care practitioners who are authorized to prescribe will be required to issue prescriptions electronically. Your most common questions, answered without playing phone tag. 1-888-327-9791 tel. 1-858-499-8009 We will review your request and send you an email invitation to complete the connection within 30 days. up. Please check your email for your new password. 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 is not-for-profit and relies on fundraising. If you are submitting via mail, the claim dispute, including all supporting documentation, should be sent to: Mercy Care Grievance System Department4500 E. Cotton Center Blvd.Phoenix, AZ 85040. Providers must register with the AHCCCS program to be eligible for payment reimbursement. It's easy to register. o Within 12 months after the date that eligibility is posted. Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. H.S. Electronic prescribing mandate information. SharpHealthPlan.com no longer supports this Internet browser. LEARN MORE . Thats why were committed to you. Many surgery and procedure names sound similar. 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. AHCCCS American Indian Health Program (AIHP) provides medically necessary services for enrolled members. Cancer Resource , Health (7 days ago) WebProvider Services / Claims ( 877 ) 853 - 8019 ( 855 ) 297 - 4247 Enrollment ( 855 ) 593 - 5757 Care Management ( 888 ) 995 - 1689 7(32) 421 - 4317 Mailing Address for , Edison health solutions provider portal eligibility, Online mba for healthcare professionals, Central texas transgender health coalition, Federal retirees open season health insurance, Atrium health one health family medicine, Eastern shore rural health patient portal, 2022 health-mental.org. Contact us Coronavirus & COVID-19 , Health (2 days ago) WebCall us at 1-858-499-8300. Sometimes you need minor wound care on a weekend, medical advice on a weeknight, or a Sharp Health Plan . You can also search for your primary care doctor to find the medical group you and your doctor belong to. Please do not use this form to convey personal or medical information. 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. You can also use this form to pay a bill for another person. A copay is a predetermined (flat) fee that you pay for health care services, in addition to what your health insurance plan pays. For eligibility, referrals, claims, credentialing, contracting, assistance with SharpConnect or any other provider-related matter, 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. To provide a more personalized experience, please select a state where SCAN is offered. Registered providers agree to abide by state laws and agree to accept the state Medicaid payment as payment in full. . *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. 700+ Doctors More than 800 primary and specialty care physicians providing exceptional care and quality health services. This position provides support and assistance to the Claims Department. 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. Sharp hospitals: 858-499-2400 Sharp Rees-Stealy: 858-499-2410 SharpCare: 858-499-2044 Sharp Specialty Groups: 858-346-4321 We look forward to helping you. For your employees' protection, we don't recommend using email to send personal medical information. Sharp Health Plan | Login Sign in Email address Password Forgot your password? Check your coverage documents through Sharp Connect. sorlando@scanhealthplan.com. The SCAN Sales Support team works with brokers and broker agencies to answer questions regarding plan benefits, eligibility, enrollment, network, formulary and other issues. 1-844-424-8886 (TTY: 1-800-716-3231) tel. Please read our. Please check your email for your new password. To select your communication preferences, including whether to have your plan materials mailed to you or sent electronically, register a member account. 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. Don't want to pick up the phone? 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. Click below to learn more about which plans, benefits and doctors are available in your area. Read up on ways to protect your colorectal health. If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services. networkmgmt@scanhealthplan.com, Office Ally Clearinghouse Or visit: https://dentaquest.com/state-plans/regions/arizona/, Mercy Care FinanceP.O. Long Beach, CA 90801-5616. You can use your Sharp Account to make a partial payment on a bill. Sharp Community has been caring for San Diegans since 1989. 1-800-837-0959 fax, Network Management *Original Claim Number: (If multiple claims, use attached spreadsheet), or Original Referral Number: * Health Plan ID Number: Patient Account Number: Service "From/To" Date: ( * Required for Claim, Billing, and Reimbursement Of Overpayment Disputes) Original Claim Amount Billed: Original Claim Amount Paid: *DISPUTE TYPE Contact us Coronavirus & COVID-19 resources for providers Learn about the basics of Medicare, how to enroll, andmore. Thank you for your understanding as we work to ensure everyone remains healthy and safe. Manage your claims. refill on a road trip. SCAN Claims Department Hours may change during holidays. Call 1-800-827-4277 or view our detailed phone directory. Mail-Order All electronic submissions shall be submitted in compliance with applicable law including HIPAA regulations and Mercy Care policies and procedures. Email your SCAN Network Management representative. To set up a hospital payment plan for a family member, call us at 858-499-2400. We are currently experiencing issues with our provider and site search tools. See if your doctor is covered under Sharp Direct Advantage Medicare plans. 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 Yog koj, los yog tej tus neeg uas koj pab ntawd, muaj lus nug txog Sharp Health Plan, koj muaj cai kom lawv muab cov ntshiab lus qhia uas tau muab sau ua koj hom lus pub dawb rau koj. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. Send us an email instead. Get free, confidential 24/7 treatment referral and information from the National Helpline. Box 982975 El Paso, TX 79998-2975. For your protection, we don't recommend using email to send personal medical information. Payment plans are only for hospital bills, and are not available for Sharp Rees-Stealy bills or for connected family members at this time. April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday Phone: 1-858-499-8100 Para hablar con un intrprete, llame al 1-800-359-2002. Para hablar con un intrprete, llame al 1-800-359-2002. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time To see an example of a bill like yours, with descriptions for each section, please review our sample bill. Enjoy retirement with a plan you cantrust. AIHP members may receive health care services from Indian Health Facilities (the Indian Health Service, tribally-operated "638" health programs, urban Indian health clinics) and other AHCCCS-registered providers.