To make changes to your payment plan, such as changing your payment method or making an extra payment, call us at 858-499-2400. 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. Encounters_Operations@scanhealthplan.com, Contact Express Scripts for Part D Coverage Reviews o Within 12 months after the date that eligibility is posted. Following your medical procedure, our billing office files a claim with your primary health insurance for the services performed. 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. 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 DentaQuest administers dental benefits for Mercy Care and Mercy Care Advantage. , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . We are making improvements to how you can view and pay your bills through your Sharp Account. Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. Required Qualifications. Claims denied for timely filing must have an explanation for the delay as well as specific documentation. 1-858-499-8009 instructions from the Health Plan and the Department of Managed Health Care. Although physicians are licensed to practice at Sharp's hospitals, they are not Sharp HealthCare employees. Iselin, New Jersey 08830. 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. Our fax number is 1-858-303-9049 . We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. If there is a problem with the information provided, and your insurance plan will not pay, our billing office attempts to correct the information and refile the claim. Don't have a Sharp Account? FraudWaste&AbuseProg@scanhealthplan.com, Office of Inspector General, U.S. Department of Health & Human Services. 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 Sharp Health Plan1-800-359-2002 . 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. Your password has been reset. H.S. Please check your email for your new password. Enrollment with Sharp Health Plan depends on contract renewal. Long Beach, CA 90806, EthicsPoint 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. Reduce risk , "We are thrilled with the support that we receive at all levels. Effective immediately, providers who are submitting paper corrected claims to Fidelis Care must follow the claim and field billing guidelines below. Interested in joining the SCAN provider network? Rated 4.5 out of 5 stars by Medicare six years in a row! For Providers. Hours may change during holidays. We know youre committed to your workforce. Call our Customer Care team at (855) 995-5004 or submit a form. With our cost-saving benefits, you could put more money back into your monthly budget. Customer care representatives are available to assist you. Easily submit pre-authorizations without extra steps. You will need to provide your personal information and the invoice or visit number from your paper statement for each payment. Sharphealthplan.com Category: Health Detail Health Contact us - Phone numbers, email, mailing address Health (2 days ago) WebCall us at 1-858-499-8300. 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. be a great option. Electronic Remittance Advice (835) [ERA]: YES. 2023, Help me find urgent care centers in my network, Consumer protections from surprise billing, permission to discuss protected health information form, Sharp Mary Birch Hospital for Women & Newborns. All of the points of contact are professional, committed and passionate about providing high-quality service. The Sharp SecureHorizons Plan by UnitedHealthcare and the Sharp Walgreens by UnitedHealthcare plans are Medicare Advantage Health Maintenance Organization (HMO) plans that include benefits in addition to those covered under Original Medicare, including Part D prescription drug coverage. P.O. o Or within 60 days after the date of the denial of a timely claim submission, whichever is later. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. 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: . P.O. We were named in the 2023 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage inCalifornia. Interfaces with other Sharp Health Plan employees to provide information as requested for other Departments. Sharp Health Plan is an HMO with a Medicare contract. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. If you feel under the weather or have certain long-term health problems, virtual care can Hours may change during holidays. You can report potential compliance issues and/or issues with fraud, waste and abuse through any of the following channels: Hours: You can use your Sharp Account to make a partial payment on a bill. Box 2906Milwaukee, WI53201-2906. With our providers, patients and health plan working together, we can ensure the best possible outcome every time. 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). VISIT THE HELPLINE Sharp Health Plan rated 5 out of 5 stars by Medicare for 2023 Every year, Medicare evaluates plans based on a 5-star rating system. Electronic prescribing mandate information. Toll-free 1-855-562-8853 TTY/TDD: 711 Our , Health (9 days ago) WebSharp Health Plan. Visit our FAQ and get your questions answered. We offer high-quality, affordable health insurance for San Diegans of all ages with You have entered a ZIP code that is not currently accepting enrollments. Covered Services , Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. *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 Hospital payments: 858-499-2400 Sharp Rees-Stealy payments: 858-499-2410 SharpCare payments: 858-499-2044 Monday through Friday: 8 am to 4:30 pm Need to pay your monthly Sharp Health Plan health insurance premium? 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. Click on the link for answers about Medicare Advantage and coverage. Use your member ID number to sign Submit authorizations. Any patient or family member with a patient safety or patient care concern or complaint that is not being addressed should promptly ask a nurse or employee to assist you in contacting a hospital manager or supervisor. networkmgmt@scanhealthplan.com, Office Ally Clearinghouse 1-877-863-3362 Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Please clearly state State Fair Hearing Request on your correspondence. These hours may change during holidays see below. Preferred Qualifications. Upang makausap ang isang tagasalin, tumawag sa 1-800-359-2002. Refer to our Provider Manual for more detailed information. If you believe your responsibility is inaccurate, please contact your insurance plan directly. These important numbers are located on your billing statement. Sharp Health Plan is an HMO with a Medicare contract. * Every year, Medicare evaluates plans based on a 5-star rating system. We are available 7 am to 8 pm, seven days a week. When you create an account on sharp.com, you will be able to view your statements for Sharp Rees-Stealy and Sharp hospitals in one place, make payments and pay all your invoices by credit card, debit card or via your checking account in one transaction. 1-888-327-9791 tel. Sharp Health Plan . Awards and recognition are subject to change each year. Policy Manuals 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. 2023, Help me find urgent care centers in my network, Sharp HealthCare Hospital Billing Customer Service, Sharp Rees-Stealy Medical Group Billing Customer Service, Douglas & Nancy Barnhart Cancer Center at Sharp Chula Vista Medical Center, Sharp Chula Vista Outpatient Nutrition Counseling Program, Sharp Chula Vista Outpatient Surgery Center, Sharp Chula Vista Pre-Anesthesia Evaluation Services, Outpatient Imaging and Cardiovascular Services, Sharp Coronado Payne Family Outpatient Pavilion, Sharp Laboratory Services at Sharp Coronado Hospital, David & Donna Long Cancer Center at Sharp Grossmont Hospital, Sharp Grossmont Hospital Burr Heart & Lung Clinic, Sharp Grossmont Hospital for Women & Newborns, Sleep Disorder Center at Sharp Grossmont Hospital, Sharp Mary Birch Hospital for Women & Newborns, Sharp McDonald Center Detox and Residential Services, Sharp McDonald Center Intensive Outpatient Services, Kevin H. Cook Infusion Center at Sharp Memorial Hospital, Sharp Allison deRose Rehabilitation Center, Sharp Metropolitan Medical Campus Pre-Anesthesia Evaluation. Sharp Community has been caring for San Diegans since 1989. For your employees' protection, we don't recommend using email to send personal medical information. You can also use this form to pay a bill for another person. MORE OPTIONS + Brokers We're here to help you succeed. 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. , , Sharp Health Plan , ' . And when you do, you'll get access to tools, tips and programs to help you reach your healthiest 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 This position provides support and assistance to the Claims Department. With Sharp Account, you can request access to a minor child's (age 11 or younger) or dependent adult's account to manage health information, view and pay bills, and more. GET INFO , Half of Americans have at least one risk factor for heart disease. 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. Give us a call with any additional questions: At this time, we are only able to grant access to accounts for dependent adults and minor children. min ph. Please visit Sharp.com or call your provider. Your password has been reset. SCAN also contracts with the California Department of Health Care Services for Medicare/Medi-Cal eligible beneficiaries. LEARN MORE , Let our members know about screening tests to help prevent or detect cervical cancer. refill on a road trip. Sharp Health Plan , 1-800-359-2002. 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. Write: For eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, please The SCAN Sales Support team works with brokers and broker agencies to answer questions regarding plan benefits, eligibility, enrollment, network, formulary and other issues. If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor. At this time, the Sharp Health Plan . Well help you choose the coverage thats right for you. SCAN Health Plan is an HMO plan with a Medicare contract. Call 1-800-827-4277 or view our detailed phone directory. These hours may change during holidays see below. REDUCE RISK , Learn how to reduce colon cancer risk by making healthy lifestyle changes. Learn about the basics of Medicare, how to enroll, andmore. Medicare Crossover To select your communication preferences, including whether to have your plan materials mailed to you or sent electronically, register a member account. Find your health plan's address (PDF). All rights reserved. Get free, confidential 24/7 treatment referral and information from the National Helpline. You can call us Monday through Friday, 8 am to 5 pm. Sharp HealthCare offers financial assistance for qualifying patients who need help with emergency or medically necessary care received in a Sharp hospital. Click hereand follow the instructions. Thank you for serving our city and San Diegans like us. Think of us as your personal health care assistant. GET INFO , Share this information with our members to help reduce their heart disease risk. Get started now. Have a computer with Internet access Can download and install a free Active-X secure FTP add-on. News & Press Releases, Can't find what you're looking for? 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. FBT: SharpHealthPlan.com no longer supports this Internet browser. Caregivers for SCAN Members can receive help with their login credentials here. Additionally, a Level Two report is provided to your vendor, which is the only accepted proof of timely filing for electronic claims. If you have questions that include personal details, like your medical history, please call your doctor directly. The monthly premium for our new VIP Plan is $0. 1-800-454-3730. 1-800-837-0959 fax, Network Management Messages received on holidays and outside of our business hours will be returned within one business day. For member-specific information or questions: 1-800-600-4441. If you have any questions about the process or your specific bill, please don't hesitate to send us an email or give us a call: We want to make it as easy as possible to manage your bills, which is why we offer paperless billing. Please print and use this permission to discuss protected health information form to allow someone to speak toSharp Rees-Stealy representativesregarding your billing information. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. We provide dedicated bilingual (English/Spanish) representatives to our members and free over-the-phone translation services in dozens of other languages. SCAN Health Plan is an HMO plan with a Medicare contract. Read up on ways to protect your colorectal health. 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. Arizona state law and your Mercy Care provider contract prohibits balance billing MC members for Medicaid covered services and benefits. Cookies must be enabled to properly use this website. Sharp Health Plan , 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. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. 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. Please include all supporting documentation with the initial claim dispute submission. Financial assistance is available for qualified low-income patients to assist with all or part of a hospital bill. Write: 1-800-359-2002 . Claim Form - Conference and Travel - Cerritos College - cms cerritos If you do not have a Sharp Account yet, you can submit a completed authorization form to request access. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time SCAN Claims Department b) Through the mail to the appropriate address: Additional information regarding claim submissions can be found in theProvider Manual. Enrollment with Sharp Health Plan depends on contract renewal. 3800 Kilroy Airport Way, Suite 100 Call us at 1-858-499-8300. SharpHealthPlan.com no longer supports this Internet browser. Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. If you'd like to pay a bill for a loved one, use our one-time payment form. In many cases, payment is sent directly to us from your health insurance provider. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. We invite you to share our women's preventive care Awards and recognition are subject to change each year. 562-508-6781 For your protection, we don't recommend using email to send personal medical information. To have your name removed from our advertising mailing list, please complete and submit the Mailing List Removal form. 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. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. For more contact information, please click hereto access the Provider Operations Manual. 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? Please read our. Our fax number is 1-858-303-9049 . , Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. 1-800-359-2002. 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. Sharp Direct Advantage is offered by Sharp Health Plan. CALL NOW. 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. FL 64: Document Control Number field must be billed with the Fidelis Care original claim number. Seven days a week, Get the most out of your pharmacy benefits, Understanding your explanation of benefits. The percentage you pay of the remaining costs depends on your plan. email us at provider.relations@sharp.comor call 1-858-499-8330. Hours may change during holidays. Click here to read the full disclaimer. Read the full disclaimer. 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. The website information you will be accessing is provided by another organization or vendor. March is Colorectal Cancer Awareness Month. Sharp Health Plan 8520 Tech Way, Ste. Talk to a real person. By clicking on this link you will be leaving the SCAN webpage and will be directed to the CMS Electronic Complaint Form. For general information or questions about quotes, rates or materials: Privacy Policy| Terms of Use| Nondiscrimination and Accessibility Requirements. Get the right support so that no questions are left unanswered. LEARN MORE . Refer to your insurance card or call your insurance provider to determine your medical group. Please check the box proving that you are not a robot. Upang makausap ang isang tagasalin, tumawag sa 1-800-359-2002. Long Beach, CA 90801-5616. Get free, confidential 24/7 treatment referral and information from the National Helpline. For the best experience on our website, please upgrade your browser to the latest version. . Enrollment with Sharp Health Plan depends on contract renewal. Search for a doctor, hospital, pharmacy or drug name. 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. Contact us. Cscs bill payer program volunteer application form return to: bill payer program council of senior centers and services of nyc, inc. 195 montague street, b-15 brooklyn, new york, ny 11201 phone: 718-858-2358 fax: 718-858-2702 personal: (this. Home Delivery from Express Scripts PharmacySM . Phone: 1-858-499-8330 am, Monday through Friday, and 24 hours a day on weekends. Please do not use this form to convey personal or medical information. TTY/TDD users: dial 711 or use the California Relay Services toll-free phone numbers. Electronic submission*: Through Electronic Clearing House You will also be able to save your preferred payment method for future use. For the best experience on our website, please upgrade your browser to the latest version. Claims and EDI 1-877-778-7226. The Health Plan encourages electronic claims submission . Complete testing with UPMC Health Plan. Learn More. We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. The request for State Fair Hearing must be filed in writing no later than 30 days after receipt of the Notice of Decision. Learn how you can help your patients through the Shingrix shortage. We offer high-quality, affordable health insurance for San Diegans of all ages with direct access to Sharp HealthCare. Call us at 1-858-499-8300. Sharp Health Plan . Enrollment in SCAN Health Plan depends on contract renewal. Caregivers for SCAN Members can receive help with their login credentials here. Provider Relations Phone Number. These hours may change during holidays see below. 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 Your most common questions, answered without playing phone tag. Visit Medicare to compare other plan ratings and find detailed reports. Sharp Direct Advantage is offered by Sharp Health Plan. Refer to your insurance card or call your insurance provider to determine your medical group. Can't find your answer below? American Indians and Alaska Natives (AI/AN) enrolled in AHCCCS or Children's Health Insurance Program (KidsCare) may choose to receive their coverage through the AHCCCS American Indian Health Program (AIHP) or one of the AHCCCS-contracted managed health plans called AHCCCS Complete Care Plans ("ACC"). It is important to note that balance billing members is prohibited under all Mercy Care health plans. MC will acknowledge a claim dispute request within five (5) business days after receipt. Please contact Member Services. Never wonder about the status of your claims again. Box 22698 Talk to a real person. 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. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. To provide a more personalized experience, please select a state where SCAN is offered. 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. Send us an email instead.