All rights reserved. We're your neighbors, so you can count on us to be accessible. The hospital's bill will be for the technical resources and supplies, such as procedures and equipment, needles and scalpels or medications. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. Payment plans are only for hospital bills, and are not available for Sharp Rees-Stealy bills or for connected family members at this time. Call 1-800-827-4277 or view our detailed phone directory. Although the hospital and the physician may use the same language to describe each charge, their bills are for separate services. direct access to Sharp HealthCare. 1-877-863-3362 Electronic Remittance Advice (835) [ERA]: YES. From April 1 to September 30 hours are 8 a.m. to 8 p.m. Monday through Friday. Electronic submission*: Through Electronic Clearing House, DentaQuest of Arizona, LLC ClaimsP.O. Sharp Direct Advantage is offered by Sharp Health Plan. Health (6 days ago) WebContact Us . Refer to your insurance card or call your insurance provider to determine your medical group. Please check your email for your new password. SharpHealthPlan.com no longer supports this Internet browser. At this time, the Sharp Health Plan . Or visit: https://dentaquest.com/state-plans/regions/arizona/, Mercy Care FinanceP.O. If you choose to send via fax, please fax your disputes to 602 351-2300. 1-800-837-0959 fax, Network Management Need Member Help Logging In? Careers Easily submit pre-authorizations without extra steps. Have a computer with Internet access Can download and install a free Active-X secure FTP add-on. Oct. 1 March 31, 8 a.m. 8 p.m., seven days a week. 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. FL 64: Document Control Number field must be billed with the Fidelis Care original claim number. Call us at 1-858-499-8300. 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 All of the points of contact are professional, committed and passionate about providing high-quality service. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time For general questions or provider portal registration, contact our Provider Account Management team. See if your doctor is covered under Sharp Direct Advantage Medicare plans. Call us at 858-627-5201, Monday to Friday, 6 am to 8 pm, so we may assist you. Enrollment in SCAN Health Plan depends on contract renewal. We know youre committed to your workforce. 1-855-562-8853 (TTY/TDD: 711) 7 am to 8 pm Pacific Time 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. Privacy Policy| Terms of Use| Nondiscrimination and Accessibility Requirements. Every hospital visit involves both physician and hospital resources. Call us at 1-858-499-8300. All rights reserved | Email: [emailprotected], Edison health solutions provider portal eligibility, Central texas transgender health coalition, Federal retirees open season health insurance, Eastern shore rural health patient portal. MC will acknowledge a claim dispute request within five (5) business days after receipt. Find out more , Stay informed. Long Beach, CA 90801-5616, Encounter Data Team Empire Plan Toll free. Learn how to create one now. With our providers, patients and health plan working together, we can ensure the best possible outcome every time. Health (3 days ago) Web101 Wood Avenue South, 8th Floor. For general questions or provider portal registration, contact our Provider Account Management team. For eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, please 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. 8 a.m. to 8 p.m., Monday Friday, from April 1 to September 30. Request a price estimate to learn more about charges for services at a Sharp hospital or Sharp Rees-Stealy location. 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. If you opt for paperless billing, you may continue to receive paper bills for some services for yourself or loved ones. Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. If you use FollowMyHealth, you may grant account access to any adult. 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. Submit authorizations. Sharp Community Medical Group 8695 Spectrum Center Blvd., 4th Floor San Diego, CA 92123 Customer Service Department Phone Number: 858-499-2550 Toll Free Phone Number: 1-877-518-7264 TDD/TTY: 711 Fax Number: 858-636-2038 Appeals Department Address Sharp Community Medical Group Attention: Appeals Department 8695 Spectrum Center Boulevard, 4th Floor A deductible is the annual amount that you must pay, out of pocket, before an insurance plan begins reimbursing for eligible services. Thank you for your understanding as we work to ensure everyone remains healthy and safe. 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. 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. Learn how you can help your patients through the Shingrix shortage. Please read our. Member Services Phone Number. For general information or questions about quotes, rates, or materials: For member-specific information or questions: Were here to help you help your patients. Please see the below for more contact options. *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. , Sharp Health Plan , ,1-800-359-2002 , Sharp Health Plan 1-800-359-2002. Learn about the basics of Medicare, how to enroll, andmore. o Or within 60 days after the date of the denial of a timely claim submission, whichever is later. These hours may change during holidays see below. Attn: Member Services Sharp Health Plan 1.800.359.2002. We are making improvements to how you can view and pay your bills through your 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. For your protection, we don't recommend using email to send personal medical information. 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 on the link for answers about Medicare Advantage and coverage. If you cannot pay the entire amount, you can set up a payment plan via Sharp Account for qualifying or eligible hospital bills. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. From Oct. 1 to March 31, hours are 8 a.m. to 8 p.m., seven days a week. TTY/TDD users can dial 711 or use the California Relay Services toll-free phonenumbers. o Within 12 months after the date that eligibility is posted. You can also search for your primary care doctor to find the medical group you and your doctor belong to. LEARN MORE . We are currently experiencing issues with our provider and site search tools. If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services. Our fax number is 1-858-303-9049. Electronic submission*: Through Electronic Clearing House Box 982975El Paso, TX 79998-2975. Enrollment with Sharp Health Plan depends on contract renewal. DentaQuest administers dental benefits for Mercy Care and Mercy Care Advantage. If a provider does not receive an acknowledgement letter within five (5) business days, the provider must contact the Appeals Department. LEARN MORE , Let our members know about screening tests to help prevent or detect cervical cancer. 1-858-499-8009 min ph. Medicare Crossover b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. 400, Wittman Drive Grand Rapids Itasca County MN - 55744 United . , , Sharp Health Plan, . 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. Sharp Health Plan is an HMO with a Medicare contract. Read up on ways to protect your colorectal health. [SBM Sharp Health Plan [ 1-800-359-2002. For the best experience on our website, please upgrade your browser to the latest version. Caregivers for SCAN Members can receive help with their login credentials here. 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. FL 22: Resubmission Code field must be billed with a "7" and the Original Reference Number field . These important numbers are located on your billing statement. Your most common questions, answered without playing phone tag. You should only sign this section if you want to cancel this authorization. Visit our FAQ and get your questions answered. 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. Compliance Officer For questions about plans and benefits, members should call: April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday To provide a more personalized experience, please select a state where SCAN is offered. Find your doctor's phone number. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Upang makausap ang isang tagasalin, tumawag sa 1-800-359-2002. You may receive a bill from us after your health insurance plan processes our bill. Additionally, a Level Two report is provided to your vendor, which is the only accepted proof of timely filing for electronic claims. For Providers. 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. Click here. However, making a partial payment will not prevent a past-due bill from going to a collections agency. Sharp Health Plan . It only takes about 15 to 20 minutes to enroll online securely. We offer high-quality, affordable health insurance for San Diegans of all ages with direct access to Sharp HealthCare. Toll-free 1-855-562-8853 TTY/TDD: 711 Our , Health (9 days ago) WebSharp Health Plan. Home Delivery from Express Scripts PharmacySM Encounters_Operations@scanhealthplan.com, Contact Express Scripts for Part D Coverage Reviews 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. All State Fair Hearing Requests must be sent in writing to the follow address: Attention: Hearing Coordinator4500 E. Cotton Center Blvd.Phoenix, AZ 85040, Vendor: Southwestern Provider Services (SPSI). 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. All rights reserved. Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. 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 1-800-827-4277 or view our detailed phone directory. To call a medical , Category: Doctor, Medical Detail Health, Health (3 days ago) WebFor eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, email us at Sharphealthplan.com Category: Health , Health (6 days ago) WebDon't hesitate to send us an email or call us Monday through Friday, from 8 am to 4:30 pm: Sharp hospitals: 858-499-2400 Sharp Rees-Stealy: 858-499-2410 SharpCare: 858-499 , Health (9 days ago) WebCall us We are available 7 am to 8 pm, seven days a week. According to the Arizona Revised Statute, Arizona Administrative Code and AHCCCS guidelines, all claim disputes related to a claim for system covered services must be filed in writing and received by the administration or the prepaid capitated provider or program contractor: Contact your Provider Relations representative for more information about electronic billing. Learn More. One of our financial counselors will provide estimated out-of-pocket costs for your care with us. * Every year, Medicare evaluates plans based on a 5-star rating system. See your patients' history. Please do not use this form to convey personal or medical information. . Enrollment in SCAN Health Plan depends on contract renewal. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. You may submit feedback about your Medicare Advantage health plan directly to Medicare. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. We could not identify your account with email address alone, please enter your first and last name to retrieve your security question. Phone: 1-858-499-8330 Seven days a week, Get the most out of your pharmacy benefits, Understanding your explanation of benefits. We are available 7 am to 8 pm, seven days a week. 1-800-359-2002. Pay Your Premium Voz y TTY (telfono de texto):1-800-855-3000. You can use this special enrollment period only once between Dec. 8, 2022, Written claim disputes must be submitted to the MC Appeals Department. 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. 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). Rated 4.5 out of 5 stars by Medicare six years in a row! Thats why were committed to you. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time MORE OPTIONS + Brokers We're here to help you succeed. Contact us to learn how to get started with Sharp Direct Advantage today! 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"). Providers must register with the AHCCCS program to be eligible for payment reimbursement. 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. Award-winning service, comprehensive coverage, plus more. Please include all supporting documentation with the initial claim dispute submission. If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services. Sharp Direct Advantage is offered by Sharp Health Plan. A copay is a predetermined (flat) fee that you pay for health care services, in addition to what your health insurance plan pays. We are currently experiencing issues with our provider and site search tools. Read the full disclaimer. 1-800-359-2002 . 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. Messages received on holidays and outside of our business hours will be returned within one business day. 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. If you are experiencing a medical emergency, call 911 or visit the nearest emergency room. We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. 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. To set up a hospital payment plan for a family member, call us at 858-499-2400. The provider should contact MC Claims and/or Network Management to seek additional information prior to initiating a claim dispute. Hours are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. ) 1-800-359-2002. You can call us Monday through Friday, 8 am to 5 pm. Please check the box proving that you are not a robot. Sharp HealthCare offers financial assistance for qualifying patients who need help with emergency or medically necessary care received in a Sharp hospital. Stay up-to-date on Sharp Health Plan-related information related to coronavirus and COVID-19. You can choose how you want to receive your billing statements and notifications via mail, email or both. If you have questions regarding your claims for DentaQuest, you can contact them directly at 844-234-9831. Contact us Coronavirus & COVID-19 , Health (2 days ago) WebCall us at 1-858-499-8300. These hours may change during holidays see below. Thank you for making us the highest member-rated health plan in California for the eighth Sharp is not-for-profit and relies on fundraising. Every year, Medicare evaluates plans based on a 5-star rating system. 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. , , Sharp Health Plan , ' . 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. 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 is accepting enrollments all year, thanks to the 5-star special enrollment period. To get started, sign in to your Sharp Account and select "Paperless Billing" from the menu options. TTY/TDD users can dial 711 or use the California Relay Services toll-free phone numbers. Sharp Health Plan , 1-800-359-2002. up. Sharp Health Plan 1.800.359.2002. If you'd like to pay a bill for a loved one, use our one-time payment form. Hours may change during holidays. Every year, Medicare evaluates plans based on a 5-star rating system. Click below to learn more about which plans, benefits and doctors are available in your area. In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) When all insurance has been processed, you are billed if there is any unpaid patient responsibility and will receive a statement in the mail. Please do not use this form to convey personal or medical information. checklist. For your employees' protection, we don't recommend using email to send personal medical information. Write: Health (1 days ago) WebSharp Health Plan Login Sign in Email address Password Forgot your password? Awards and recognition are subject to change each year. 1-800-359-2002. You can pay by credit or debit card or by check. News & Press Releases, Can't find what you're looking for? Please clearly state State Fair Hearing Request on your correspondence. Registered providers agree to abide by state laws and agree to accept the state Medicaid payment as payment in full. Send us an email instead. Messages received on holidays and outside of our business hours will be returned within one business day. Find a 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 P.O. GET INFO , Share this information with our members to help reduce their heart disease risk. Get the right support so that no questions are left unanswered. Cookies must be enabled to properly use this website. The website information you will be accessing is provided by another organization or vendor. A claim dispute is a dispute involving the payment of a claim, denial of a claim, imposition of a sanction or reinsurance. Don't have a Sharp Account? If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor. sorlando@scanhealthplan.com. 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. With our providers, patients and health plans working together, we can ensure the best possible outcome every time. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. Please visit Sharp.com or call your provider. Get free, confidential 24/7 treatment referral and information from the National Helpline. 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. PracticeBridge. Effective immediately, providers who are submitting paper corrected claims to Fidelis Care must follow the claim and field billing guidelines below. Your password has been reset. SharpCare Medical Group patients can use this form to make online payments. 1-844-424-8886 (TTY: 1-800-716-3231) tel. The Health Plan provides an in-process claims list on payment vouchers, a secure provider portal listing claims status, and a customer service area to handle telephone inquiries. To see an example of a bill like yours, with descriptions for each section, please review our sample bill. Fee-for-Service Fee Schedules, Contact Us Click here to read the full disclaimer. Phone: 1-858-499-8200. 8 a.m. to 8 p.m., Seven days a week, from October 1 to March 31. and Nov. 30, 2023. Find a Due to COVID-19 restrictions, the Sharp Health Plan office is not open to visitors at this time. The Health Plan encourages electronic claims submission . Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. Claims denied for timely filing must have an explanation for the delay as well as specific documentation. Ready for comprehensive Medicare Advantage coverage that could save you money? Quality care depends on clear communication between you and your patients. Interfaces with other Sharp Health Plan employees to provide information as requested for other Departments. 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.