Please clearly state State Fair Hearing Request on your correspondence. A claim dispute is a dispute involving the payment of a claim, denial of a claim, imposition of a sanction or reinsurance. California Sharp Medicare Advantage Plans | UHCprovider.com Thank you for making us the highest member-rated health plan in California for the eighth Box 982975El Paso, TX 79998-2975. 2023 SCAN Health Plan. You may also mail your payment to the address listed on your statement. 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. April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday min ph. Refer to your insurance card or call your insurance provider to determine your medical group. Find a local SCAN Representative in your neighborhood who speaks your language. Upang makausap ang isang tagasalin, tumawag sa 1-800-359-2002. 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. Call us at 1-858-499-8300. Write: Real Time Claim Status (RTS): NO. Need Member Help Logging In? Mercy Care Claims Department P. O. Hours are 8 a.m. to 8 p.m. from April 1 to Sept. 30, Monday through Friday. 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. Quality care depends on clear communication between you and your patients. Complete testing with UPMC Health Plan. www.ethicspoint.com, SCAN SIU Team Coverage Determinations If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor. Subscribe to Newsletters 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. 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. PracticeBridge. Email your SCAN Network Management representative. Enrollment with Sharp Health Plan depends on contract renewal. Claims Mailing Address: Medical. . Were your neighbors, so you can count on us to be accessible. Interested in joining the SCAN provider network? 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: . When all insurance has been processed, you are billed if there is any unpaid patient responsibility and will receive a statement in the mail. By clicking on this link you will be leaving the SCAN webpage and will be directed to the CMS Electronic Complaint Form. http://oig.hhs.gov/fraud/report-fraud/index.asp. Yog koj xav nrog ib tug neeg txhais lus tham, hu rau 1-800-359-2002. 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. These important numbers are located on your billing statement. By clicking on this link you will be leaving the SCAN webpage and will be directed to the CMS Electronic Complaint Form. * Every year, Medicare evaluates plans based on a 5-star rating system. email us at provider.relations@sharp.comor call 1-858-499-8330. Address. Stay up-to-date on Sharp Health Plan-related information related to coronavirus and COVID-19. The provider must follow all applicable laws, policies and contractual requirements when filing. Easily submit pre-authorizations without extra steps. b) Through the mail to the appropriate address: Additional information regarding claim submissions can be found in theProvider Manual. You can choose how you want to receive your billing statements and notifications via mail, email or both. 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. Upang makausap ang isang tagasalin, tumawag sa 1-800-359-2002. Click on the link for answers about Medicare Advantage and coverage. REDUCE RISK , Learn how to reduce colon cancer risk by making healthy lifestyle changes. We offer high-quality, affordable health insurance for San Diegans of all ages with 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. Home Delivery from Express Scripts PharmacySM Submit authorizations. If you have questions that include personal details, like your medical history, please call your doctor directly. http://oig.hhs.gov/fraud/report-fraud/index.asp. Our fax number is 1-858-303-9049 . 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. Were here to help you help your patients. 1 Practice Locations Offering you and your family convenient access to care where you work, live and play. , , Sharp Health Plan , ' . Or visit: https://dentaquest.com/state-plans/regions/arizona/, Mercy Care FinanceP.O. Have a computer with Internet access Can download and install a free Active-X secure FTP add-on. Please visit Sharp.com or call your provider. To set up a hospital payment plan for a family member, call us at 858-499-2400. Click here. Enrollment in SCAN Health Plan depends on contract renewal. Our fax number is 1-858-303-9049. We were named in the 2023 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage inCalifornia. 1-800-837-0959 fax, Network Management Sharp Health Plan is an HMO with a Medicare contract. Forms, guides and other resources - Sharp Health Plan SCAN Directory - SCAN Health Plan Send us an email instead. Read the full disclaimer. We are currently experiencing issues with our provider and site search tools. Non-contracted providers can refer to the AHCCCS fee schedule for reimbursement information. Messages received on holidays and outside of normal business hours will be returned within one business day. Looking for Provider Login or Agent/Broker Login? Policy Manuals Go to www.sharphealthplan.com/payment to pay now. Learn about the basics of Medicare, how to enroll, andmore. Sharp Community has been caring for San Diegans since 1989. 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. MORE OPTIONS + Brokers We're here to help you succeed. and Nov. 30, 2023. Learn More. Don't have a Sharp Account? Need to pay a medical bill or copay? Oct. 1 March 31, 8 a.m. 8 p.m., seven days a week, Write: Seffrah Orlando, Senior Public Relations Specialist 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. 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: 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. You can call us Monday through Friday, 8 am to 6 pm. Award-winning service, comprehensive coverage, plus more. You can call us Monday through Friday, 8 am to 5 pm. 8 a.m. to 8 p.m., Monday Friday, from April 1 to September 30. There is a problem with enrollment at this time. DentaQuest administers dental benefits for Mercy Care and Mercy Care Advantage. email us at provider.relations@sharp.com or call1-858-499-8330. AHCCCSOnline Website Careers If you believe your responsibility is inaccurate, please contact your insurance plan directly. Sharp Health Plan Contact Us; Forgot Username; Forgot Password; Schedule a Demo (855) 757-6060 Enrollment with Sharp Health Plan depends on contract renewal. . Sharp Health Plan is accepting enrollments all year, thanks to the 5-star special enrollment period. Sharp Health Plan . Find out more , Stay informed. 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 Hours are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. Don't want to pick up the phone? . Think of us as your personal health care assistant. 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. Sharp Health Plan | Login Sign in Email address Password Forgot your password? Medicare Crossover 1-800-HHS-TIPS (1-800-447-8477) 1-844-424-8886 (TTY: 1-800-716-3231) tel. You can also search for your primary care doctor to find the medical group you and your doctor belong to. Oct. 1 March 31, 8 a.m. 8 p.m., seven days a week. Clerical Assistant II- Claims / Finance /Healthplan- Tech Way / Full We are working to resolve this as quickly as possible. . Our fax number is 1-858-303-9049 . Contacts - San Diego - Sharp Community Medical Group - SCMG Sharp Health Plan Claims Address These important numbers are located on your billing statement. Financial assistance is available for qualified low-income patients to assist with all or part of a hospital bill. Send us an email instead. We will review your request and send you an email invitation to complete the connection within 30 days. 1-800-359-2002. Enjoy retirement with a plan you cantrust. And when you do, you'll get access to tools, tips and programs to help you reach your healthiest you. To provide a more personalized experience, please select a state where SCAN is offered. Call 1-800-827-4277 or view our detailed phone directory. Contact us Coronavirus & COVID-19 , Health (2 days ago) WebCall us at 1-858-499-8300. Make sure your contact information is up to date. With our providers, patients and health plans working together, we can ensure the best possible outcome every time. If you cannot pay the entire amount, you can set up a payment plan via Sharp Account for qualifying or eligible hospital bills. You may submit feedback about your Medicare Advantage health plan directly to Medicare. Required Qualifications. You can call us Monday through Friday, 8 am to 5 pm. a) Claims must be legible and suitable for imaging and/or microfilming for permanent record retention. If you are experiencing a medical emergency, call 911 or visit the nearest emergency room. As reported in Medicare & You 2023 member rating of plan. TTY/TDD users can dial 711 or use the California Relay Services toll-free phonenumbers. Sharp HealthCare Phone Numbers and Email - San Diego Diploma or Equivalent; Essential . Sharp Health Plan . Contact your Network Management representative for more information about electronic billing. Get the right support so that no questions are left unanswered. Call 1-800-827-4277 or view our detailed phone directory. Claims :: The Health Plan Effective January 1, 2022, all California health care practitioners who are authorized to prescribe will be required to issue prescriptions electronically. We are making improvements to how you can view and pay your bills through your Sharp Account. The program also provides coverage for preventive and behavioral health care services. 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"). 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 1.800.359.2002. Arizona state law and your Mercy Care provider contract prohibits balance billing MC members for Medicaid covered services and benefits. For Providers. MORE OPTIONS + Brokers To pay by credit card over the phone, please call Patient Financial Services: Check, cashier's check, money order and major credits cards are accepted at all Sharp HealthCare hospital and clinic locations. networkmgmt@scanhealthplan.com, Office Ally Clearinghouse Visit Medicare to compare other plan ratings and find detailed reports. 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? Now its our turn to serveyou. Enrollment with Sharp Health Plan depends on contract renewal. Please include all supporting documentation with the initial claim dispute submission. American Indian Health Program - azahcccs.gov We are working to resolve this as quickly as possible. o Or within 60 days after the date of the denial of a timely claim submission, whichever is later. You can also search for your primary care doctor to find the medical group you and your doctor belong to. 1-800-359-2002. Reduce risk , "We are thrilled with the support that we receive at all levels. 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. Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. Fax: 1-858-303-9049 Get free, confidential 24/7 treatment referral and information from the National Helpline. Need to pay a medical bill or copay? Contact us Coronavirus & COVID-19 resources for providers Check your coverage documents through Sharp Connect. Box 22698 Talk to a real person. Paper Corrected Claim Submission Updates | Fidelis Care If you opt for paperless billing, you may continue to receive paper bills for some services for yourself or loved ones. 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 Privacy Policy| Terms of Use| Nondiscrimination and Accessibility Requirements. Frequently Asked Billing Questions | Sharp HealthCare Effective immediately, providers who are submitting paper corrected claims to Fidelis Care must follow the claim and field billing guidelines below. Claims and EDI 1-877-778-7226. SharpHealthPlan.com no longer supports this Internet browser. Thank you for your understanding as we work to ensure everyone remains healthy and safe. Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. 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 general information or questions about quotes, rates or materials: ) 1-800-359-2002. Every hospital visit involves both physician and hospital resources. You can also use Sharp Account to view itemized bills, check your current balance and view your payment history. 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. 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. Find a To provide a more personalized experience, please select a state where SCAN is offered. Follow the prompts to set your billing preferences. We're your neighbors, so you can count on us to be accessible. For the best experience on our website, please upgrade your browser to the latest version. ni chuyn vi mt thng dch vin, xin gi 1-800-359-2002. 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. Sharp Health Plan1-800-359-2002 . , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . Payment plans are only for hospital bills, and are not available for Sharp Rees-Stealy bills or for connected family members at this time. SCAN also contracts with the California Department of Health Care Services for Medicare/Medi-Cal eligible beneficiaries. Enrollment in SCAN Health Plan depends on contract renewal. , , Sharp Health Plan , ' . Every year, Medicare evaluates plans based on a 5-star rating system. Members Brokers Providers Employers Members Talk to a real person. 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. UPMC Health Plan claims. Enjoy direct access to Sharp HealthCare and The Sharp Experience.*. If you choose to send via fax, please fax your disputes to 602 351-2300. AHCCCS (Arizona Health Care Cost Containment System) is Arizonas Medicaid Managed Care Program. Box 90640Phoenix, AZ 85066. be a great option. 1-800-359-2002 . To have your name removed from our advertising mailing list, please complete and submit the Mailing List Removal form. Claims information - Sharp Health Plan Write: Customer care representatives are available to assist you. SCAN Claims Department Visit our FAQ and get your questions answered. sorlando@scanhealthplan.com. We're here to help shed light on the bills you may receive. TTY/TDD users can dial 711 or use the California Relay Services toll-free phone numbers. 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. Your password has been reset. FL 64: Document Control Number field must be billed with the Fidelis Care original claim number. The SCAN Sales Support team works with brokers and broker agencies to answer questions regarding plan benefits, eligibility, enrollment, network, formulary and other issues. 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 have questions about eligibility, costs or what kind of coverage you can expect give us a call today! 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. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. ", - Sherri R., Director of Benefits & HR Information Systems, Palomar Health. 1-858-499-8211 MORE OPTIONS + Plans purchased through Covered California If you purchased your plan directly from Covered California , Sharphealthplan.com Claims denied for timely filing must have an explanation for the delay as well as specific documentation. 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. The Health Plan encourages electronic claims submission . This means the hospital and each of your treating physicians will send you a bill for their parts of your care. GET INFO , Share this information with our members to help reduce their heart disease risk. BOX 22616 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. Hours may change during holidays. Please do not use this form to convey personal or medical information. Box 22698 Long Beach, CA 90801-5616. Registered providers agree to abide by state laws and agree to accept the state Medicaid payment as payment in full. 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. For the best experience on our website, please upgrade your browser to the latest version. SCAN Health Plan Attn: Member Services Call us at 1-858-499-8300. You can pay by credit or debit card or by check. If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services. 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 For the best experience on our website, please upgrade your browser to the latest version. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. 1-888-705-7226 562-508-6781 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) 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. To see an example of a bill like yours, with descriptions for each section, please review our sample bill. Please check your email for your new password. Need Member Help Logging In? 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. Sharp Health Plan: Fill & Download for Free - cocodoc.com Our updated Mercy Care Claims Processing Manualis now available to assist you with any claims or billing questions you may have.
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