Your most common questions, answered without playing phone tag. You can choose how you want to receive your billing statements and notifications via mail, email or both. Enrollment with Sharp Health Plan depends on contract renewal. Preferred Qualifications. SharpHealthPlan.com no longer supports this Internet browser. , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . Need to pay a medical bill or copay? To select your communication preferences, including whether to have your plan materials mailed to you or sent electronically, register a member account. Our fax number is 1-858-303-9049. , , Sharp Health Plan , ' . Find out more , Stay informed. We offer high-quality, affordable health insurance for San Diegans of all ages with direct access to Sharp HealthCare. Mercy Care Claims Department P. O. FBT: SharpHealthPlan.com no longer supports this Internet browser. Think of us as your personal health care assistant. Every year, Medicare evaluates plans based on a 5-star rating system. Don't want to pick up the phone? 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. email us at provider.relations@sharp.comor call 1-858-499-8330. 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. , , Sharp Health Plan, . Para hablar con un intrprete, llame al 1-800-359-2002. To include supporting documentation, such as members medical records, clearly label and send to the Claims Department at the correct address. Make sure your contact information is up to date. The physician's bill will be for the professional services. Dr. Alan Kadet's office New York, NY Check eligibility & benefits. Sharp Health Plan is an HMO with a Medicare contract. 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. Sharp HealthCare offers financial assistance for qualifying patients who need help with emergency or medically necessary care received in a Sharp hospital. Every year, Medicare evaluates plans based on a 5-star rating system. As reported in Medicare & You 2023 member rating of plan. We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. Looking for Provider Login or Agent/Broker Login? You can report potential compliance issues and/or issues with fraud, waste and abuse through any of the following channels: Hours: refill on a road trip. 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. Read the full disclaimer. Send us an email instead. Mercy Care's electronic claim submission vendors, https://dentaquest.com/state-plans/regions/arizona/, Augmentative and Alternative Communication. 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. Cash is accepted at hospitals only. For general information or questions about quotes, rates or materials: Talk to a real person. Providers must register with the AHCCCS program to be eligible for payment reimbursement. The General Data Protection Regulation (GDPR) governs the processing of personal information gathered from individuals while they are in the European Union (EU) and parts of the EEA (European Economic Area, which currently includes Iceland, Lichtenstein and Norway). Manage your claims. 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. All rights reserved. Fax: 1-858-303-9049 Messages received on holidays and outside of normal business hours will be returned within one business day. Sharp Health Plan is an HMO with a Medicare contract. Out-of-State Toll Free: 1-800-523-0231, How to Apply Read the update , Share these tips with our members to help them reduce their risk of colon cancer. AHCCCS American Indian Health Program (AIHP) provides medically necessary services for enrolled members. Phone: 1-858-499-8200. Quality care depends on clear communication between you and your patients. http://oig.hhs.gov/fraud/report-fraud/index.asp. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. Written claim disputes must be submitted to the MC Appeals Department. 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. MC will acknowledge a claim dispute request within five (5) business days after receipt. 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. Please submit a copy of the front and back of your statement and a brief explanation of your situation, along with any other relevant information, to the address of your health plan. Arizona state law and your Mercy Care provider contract prohibits balance billing MC members for Medicaid covered services and benefits. 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. Your password has been reset. 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. Eligibility, referrals, or claims: 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. direct access to Sharp HealthCare. Award-winning service, comprehensive coverage, plus more. These important numbers are located on your billing statement. Once you have submitted our request form, we will review your request and send you an email invitation to complete the connection within 30 business days. Sharp Direct Advantage is offered by Sharp Health Plan. 1-888-705-7226 * Every year, Medicare evaluates plans based on a 5-star rating system. 1-562-308-3699 fax You can join today, right from your laptop or phone. If you prefer not to create an account, you can still pay your bill online by using our one-time payment form. Messages received on holidays and outside of normal business hours will be returned within one business day. For example, if you had an emergency room visit that required X-rays and lab tests, you may receive a bill from the hospital for technical resources, a bill from the emergency room physician for professional services, a bill from the radiologist for interpreting your X-rays and a bill from the pathologist for analyzing specimens from your lab tests. Phone: 1-858-499-8100 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. 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). Privacy Policy| Terms of Use| Nondiscrimination and Accessibility Requirements. b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. Caregivers for SCAN Members can receive help with their login credentials here. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. We are currently experiencing issues with our provider and site search tools. Enjoy direct access to Sharp HealthCare and The Sharp Experience.*. Empire Plan Toll free. Need Member Help Logging In? Box 90640Phoenix, AZ 85066. By clicking on this link you will be leaving the SCAN webpage and will be directed to the CMS Electronic Complaint Form. 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. 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. Contracted providers can find reimbursement information in their Mercy Care contracts. 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? Every year, Medicare evaluates plans based on a 5-star rating system. Please print and use this permission to discuss protected health information form to allow someone to speak toSharp Rees-Stealy representativesregarding your billing information. Our fax number is 1-858-303-9049 . Caregivers for SCAN Members can receive help with their login credentials here. Cookies must be enabled to properly use this website. Sharp is not-for-profit and relies on fundraising. Please do not use this form to convey personal or medical information. Effective January 1, 2022, all California health care practitioners who are authorized to prescribe will be required to issue prescriptions electronically. a) Claims must be legible and suitable for imaging and/or microfilming for permanent record retention. www.ethicspoint.com, SCAN SIU Team We were named in the 2023 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage inCalifornia. Complete ALL required fields, and include additional documentation when necessary. Refer to your insurance card or call your insurance provider to determine your medical group. Search Sharp Health Plan PayerID SHP01 and find the complete info about Sharp Health Plan Insurance Type, LOB, ENR, RTE, RTS, ERA, SEC, Customer Service Number and more . 1-855-562-8853 (TTY/TDD: 711) 7 am to 8 pm Pacific Time Toll-free 1-855-562-8853 TTY/TDD: 711 Our , Health (9 days ago) WebSharp Health Plan. Click here to read the full disclaimer. 1-888-327-9791 tel. Find your doctor's phone number. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. email us at provider.relations@sharp.com or call1-858-499-8330. The monthly premium for our new VIP Plan is $0. [SBM Sharp Health Plan [ 1-800-359-2002. We're your neighbors, so you can count on us to be accessible. Sharp Health Plan , 1-800-359-2002. SCAN Health Plan Read the full disclaimer. 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. 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. Electronic submission*: Through Electronic Clearing House, DentaQuest of Arizona, LLC ClaimsP.O. This service is free of charge and also includes American Sign Language translators. There is a problem with enrollment at this time. Sharp Direct Advantage is offered by Sharp Health Plan. Get started now. Need to pay a medical bill or copay? Shop plans 1 2 3 4 5 6 Enroll online Talk to a , Health (8 days ago) WebThe original claim must be received by The Health Plan 180 days from the date of service. Call our dedicated Customer Care provider line: You may need to complete a final step to connect to your family member in FollowMyHealth. Send us an email instead. If you opt for paperless billing, you may continue to receive paper bills for some services for yourself or loved ones. Were your neighbors so you can count on us to be accessible. Box 982975 El Paso, TX 79998-2975. Customer care representatives are available to assist you. Additionally, a Level Two report is provided to your vendor, which is the only accepted proof of timely filing for electronic claims. . Call 1-800-827-4277 or view our detailed phone directory. Contact us Coronavirus & COVID-19 resources for providers 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time Don't have a Sharp Account? Learn how you can help your patients through the Shingrix shortage. For the best experience on our website, please upgrade your browser to the latest version. 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). Looking for Provider Login or Agent/Broker Login? To see an example of a bill like yours, with descriptions for each section, please review our sample bill. If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor. 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. Click here to read the full disclaimer. Contact Sharp Health Plan to get answers on anything from paying a bill to signing up for coverage. BOX 22616 If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time If you believe your responsibility is inaccurate, please contact your insurance plan directly. March is Colorectal Cancer Awareness Month. This means the hospital and each of your treating physicians will send you a bill for their parts of your care. Many surgery and procedure names sound similar. Long Beach, CA 90806, EthicsPoint 1-800-454-3730. Click below to learn more about which plans, benefits and doctors are available in your area. Talk to a real person. Interfaces with other Sharp Health Plan employees to provide information as requested for other Departments. With our cost-saving benefits, you could put more money back into your monthly budget. Enrollment in SCAN Health Plan depends on contract renewal. 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. FL 22: Resubmission Code field must be billed with a "7" and the Original Reference Number field . You can call us Monday through Friday, 8 am to 5 pm. Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. 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. 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. Contact us Coronavirus & COVID-19 , Health (2 days ago) WebCall us at 1-858-499-8300. 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. Policy Manuals MORE OPTIONS + Brokers We're here to help you succeed. MORE OPTIONS + Brokers We're here to help you succeed. Cookies must be enabled to properly use this website. 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. Provider Account Management: 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. Provider Relations Phone Number. Registered providers agree to abide by state laws and agree to accept the state Medicaid payment as payment in full. If you have questions that include personal details, like your medical history, please call your doctor directly. Need Member Help Logging In? 1-877-863-3362 Due to California privacy regulations, the information you can access for minor patients will depend on their age. 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. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. Required Qualifications. Visit our provider website and Portal for helpful resources including information on member eligibility, claims, medical policies, pharmacy, CMS programs, and more. 562-508-6781 Non-contracted providers can refer to the AHCCCS fee schedule for reimbursement information. Request a price estimate to learn more about charges for services at a Sharp hospital or Sharp Rees-Stealy location. To provide a more personalized experience, please select a state where SCAN is offered. With our providers, patients and health plans working together, we can ensure the best possible outcome every time. Sharp Health Plan1-800-359-2002 . A deductible is the annual amount that you must pay, out of pocket, before an insurance plan begins reimbursing for eligible services. SharpHealthPlan.com no longer supports this Internet browser. , , Sharp Health Plan , ' . For member-specific information or questions: For our members' protection, we don't recommend using email to send personal medical information. 700+ Doctors More than 800 primary and specialty care physicians providing exceptional care and quality health services. 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: . You will also be able to save your preferred payment method for future use. 1-844-424-8886 (TTY: 1-800-716-3231) tel. 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. To set up a hospital payment plan for a family member, call us at 858-499-2400. Box 982975El Paso, TX 79998-2975. We are available 7 am to 8 pm, seven days a week. Box 22698 Long Beach, CA 90801-5616. Refer to your insurance card or call your insurance provider to determine your medical group. 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.