For your protection, we don't recommend using email to send personal medical information. 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: 1-844-424-8886 (TTY: 1-800-716-3231) tel. 1-877-251-5896 fax Hours may change during holidays. If a provider does not receive an acknowledgement letter within five (5) business days, the provider must contact the Appeals Department. Submit authorizations. 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. Write: SCAN Claims Department P.O. You have entered a ZIP code that is not currently accepting enrollments. SharpHealthPlan.com no longer supports this Internet browser. For the best experience on our website, please upgrade your browser to the latest version. We know youre committed to your workforce. 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. Think of us as your personal health care assistant. DentaQuest administers dental benefits for Mercy Care and Mercy Care Advantage. Compliance Officer 1-855-562-8853 (TTY/TDD: 711) 7am to 8pm Pacific Time [SBM Sharp Health Plan [ 1-800-359-2002. In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) 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. Check your coverage documents through Sharp Connect. Real Time Claim Status (RTS): NO. 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: . Many surgery and procedure names sound similar. Member Services Phone Number. If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor. Although the hospital and the physician may use the same language to describe each charge, their bills are for separate services. 1-888-327-9791 tel. * Every year, Medicare evaluates plans based on a 5-star rating system. For member-specific information or questions: a) Claims must be legible and suitable for imaging and/or microfilming for permanent record retention. Pay Your Premium 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. Get helpful reminders about how to comply with the timely access laws, which outline maximum wait times for phone calls and appointment requests. You can call us Monday through Friday, 8 am to 5 pm. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. Cookies must be enabled to properly use this website. Click on the link for answers about Medicare Advantage and coverage. Enrollment in SCAN Health Plan depends on contract renewal. Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. We could not identify your account with email address alone, please enter your first and last name to retrieve your security question. If you do not have a Sharp Account yet, you can submit a completed authorization form to request access. By clicking on this link you will be leaving the SCAN webpage and will be directed to the CMS Electronic Complaint Form. For the best experience on our website, please upgrade your browser to the latest version. We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations. Your most common questions, answered without playing phone tag. 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 believe your responsibility is inaccurate, please contact your insurance plan directly. 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. ) 1-800-359-2002. Complete ALL required fields, and include additional documentation when necessary. MC may request an extension of up to 45 days, if necessary. Enrollment in SCAN Health Plan depends on contract renewal. Box 982975El Paso, TX 79998-2975. and Nov. 30, 2023. am, Monday through Friday, and 24 hours a day on weekends. Written claim disputes must be submitted to the MC Appeals 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. Contact your software vendor directly for questions about your electronic billing. For member-specific information or questions: For our members' protection, we don't recommend using email to send personal medical information. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. We're your neighbors, so you can count on us to be accessible. 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. Find a Seven days a week, Get the most out of your pharmacy benefits, Understanding your explanation of benefits. For your employees' protection, we don't recommend using email to send personal medical information. 1-877-251-5896 fax Home Delivery from Express Scripts Pharmacy . 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. Please do not use this form to convey personal or medical information. If you have questions about eligibility, costs or what kind of coverage you can expect give us a call today! . Sometimes you need minor wound care on a weekend, medical advice on a weeknight, or a Sharp Health Plan . Caregivers for SCAN Members can receive help with their login credentials here. Hours are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. Please include all supporting documentation with the initial claim dispute submission. It is important to note that balance billing members is prohibited under all Mercy Care health plans. 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. Sharp is not-for-profit and relies on fundraising. Enjoy direct access to Sharp HealthCare and The Sharp Experience.*. 1-858-499-8300. You can use your Sharp Account to make a partial payment on a bill. You may submit feedback about your Medicare Advantage health plan directly to Medicare. 1-858-499-8009 SCAN also contracts with the California Department of Health Care Services for Medicare/Medi-Cal eligible beneficiaries. . If you'd like to pay a bill for a loved one, use our one-time payment form. Please see the below for more contact options. Hours may change during holidays. Providers must register with the AHCCCS program to be eligible for payment reimbursement. Box 22698 Long Beach, CA 90801-5616. AHCCCS American Indian Health Program (AIHP) provides medically necessary services for enrolled members. Contact Sharp HealthCare To find a doctor or register for a class or event, call us at 1-800-827-4277. Fax: 1-858-303-9062 Covered Services FL 64: Document Control Number field must be billed with the Fidelis Care original claim number. UPMC Health Plan claims. Sharp Health Plan is an HMO with a Medicare contract. MORE OPTIONS + Brokers March is Colorectal Cancer Awareness Month. Stay up-to-date on Sharp Health Plan-related information related to coronavirus and COVID-19. Following your medical procedure, our billing office files a claim with your primary health insurance for the services performed. 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). MORE OPTIONS + Plans purchased through Covered California If you purchased your plan directly from , Health (9 days ago) WebContact Sharp HealthCare To find a doctor or register for a class or event, call us at 1-800-827-4277. If you have questions that include personal details, like your medical history, please call your doctor directly. Call us We are available 7 am to 8 pm, seven days a week. 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. For general questions or provider portal registration, contact our Provider Account Management team. Learn More. Use your member ID number to sign 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). Policy Manuals min ph. You can also use this form to pay a bill for another person. MORE OPTIONS + Brokers We're here to help you succeed. Home Delivery from Express Scripts PharmacySM 200 San Diego, CA 92123-1450 Fax: (619) 740-8571 7. Electronic submission*: Through Electronic Clearing House Para hablar con un intrprete, llame al 1-800-359-2002. , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . We offer high-quality, affordable health insurance for San Diegans of all ages with direct access to Sharp HealthCare. Please contact Member Services. SCAN Health Plan is an HMO plan with a Medicare contract. You should only sign this section if you want to cancel this authorization. Our fax number is 1-858-303-9049 . The monthly premium for our new VIP Plan is $0. For questions about plans and benefits, members should call: April 1 Sept. 30, 8 a.m. 8 p.m., Monday Friday Sharp HealthCare offers financial assistance for qualifying patients who need help with emergency or medically necessary care received in a Sharp hospital. Every hospital visit involves both physician and hospital resources. You can pay by credit or debit card or by check. Awards and recognition are subject to change each year. Please read our. Claims and EDI 1-877-778-7226. These hours may change during holidays see below. 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. Learn how , These two screening tests can help prevent cervical cancer or detect it early. Our fax number is 1-858-303-9049 . Members Brokers Providers Employers Members Talk to a real person. For general information or questions about quotes, rates or materials: , 1-800-359-2002 , Sharp Health Plan , 1-800-359-2002 . Sharp Health Plan . MORE OPTIONS + Brokers We're here to help you succeed. 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. We are working to resolve this as quickly as possible. b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. sorlando@scanhealthplan.com. Cookies must be enabled to properly use this website. Sharp Health Plan 8520 Tech Way, Ste. To provide a more personalized experience, please select a state where SCAN is offered. Every year, Medicare evaluates plans based on a 5-star rating system. 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. ", - Sherri R., Director of Benefits & HR Information Systems, Palomar Health. For Providers. direct access to Sharp HealthCare. 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. Interested in joining the SCAN provider network? Sharp Direct Advantage is offered by Sharp Health Plan. Request a price estimate to learn more about charges for services at a Sharp hospital or Sharp Rees-Stealy location. Sharp Health Plan . Write: The percentage you pay of the remaining costs depends on your plan. 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. Due to California privacy regulations, the information you can access for minor patients will depend on their age. 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. All rights reserved. 1-877-7NYSHIP (1-877-769-7447), choose UnitedHealthcare . 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. We are currently experiencing issues with our provider and site search tools. If you do not want to leave our website, please click the X. We were named in the 2023 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage inCalifornia. 8 a.m. to 8 p.m., Monday Friday, from April 1 to September 30. Your bill will list the services you received under the "Summary of Patient Services." SCAN Health Plan Now its our turn to serveyou. Enrollment with Sharp Health Plan depends on contract renewal. Address. Sharp Direct Advantage is offered by Sharp Health Plan. Looking for Provider Login or Agent/Broker Login? 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. Caregivers for SCAN Members can receive help with their login credentials here. Caregivers for SCAN Members can receive help with their login credentials here. If you use FollowMyHealth, you may grant account access to any adult. For credentialing inquiries about your application or credentialing status, contact our Credentialing team. SharpCare Medical Group patients can use this form to make online payments. H5386_2022 Medicare Website_Rev10 Page Last Updated: 1/03/2023 Please check the box proving that you are not a robot. PracticeBridge. 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. 1-888-705-7226 News & Press Releases, Can't find what you're looking for? Claim Form - Conference and Travel - Cerritos College - cms cerritos If you are experiencing a medical emergency, call 911 or visit the nearest emergency room. Yog koj xav nrog ib tug neeg txhais lus tham, hu rau 1-800-359-2002. 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? Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Phone: 1-858-499-8200. Thank you for your understanding as we work to ensure everyone remains healthy and safe. It is the responsibility of each provider or practitioner submitting claims to become familiar with billing and coverage and requirements. Phone: 1-858-499-8330 Diploma or Equivalent; Essential . checklist. To make changes to your payment plan, such as changing your payment method or making an extra payment, call us at 858-499-2400. Please read our. Empire Plan Toll free. Out-of-State Toll Free: 1-800-523-0231, How to Apply 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? You can use this special enrollment period only once between Dec. 8, 2022, Click here to 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. We will review your request and send you an email invitation to complete the connection within 30 days. Find out more , Stay informed. Go to www.sharphealthplan.com/payment to pay now. You can call us Monday to Friday, 8 am to 6 pm. GET INFO , Half of Americans have at least one risk factor for heart disease. Explore SCAN plans available in your area! Sharp health plan provider phone number, Health (2 days ago) WebFor eligibility, referrals, claims, credentialing, contracting, assistance with Sharp Connect or any other provider-related matter, email us at [emailprotected] or call 1-858-499-8330. Messages received on holidays and outside of normal business hours will be returned within one business day. 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. Please visit Sharp.com or call your provider. All rights reserved. Were your neighbors, so you can count on us to be accessible. Rated 4.5 out of 5 stars by Medicare six years in a row! P.O. Long Beach, CA 90806, EthicsPoint Clickherefor up-to-date information on COVID-19 testing, vaccines, and care. email us at provider.relations@sharp.com or call1-858-499-8330. Contact us to learn how to get started with Sharp Direct Advantage today! As reported in Medicare & You 2023 member rating of plan. Read up on ways to protect your colorectal health. Typically, you will pay your percentage of costs until you reach your plan's annual out-of-pocket maximum. Seffrah Orlando, Senior Public Relations Specialist 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. A copay is a predetermined (flat) fee that you pay for health care services, in addition to what your health insurance plan pays. Phone: 1-858-499-8100 *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 b) Through the mail to the appropriate address: Additional information regarding claim submissions can be found in theProvider Manual. Have a computer with Internet access Can download and install a free Active-X secure FTP add-on. Email your SCAN Network Management representative. 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. 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). 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 general information or questions about quotes, rates or materials: Talk to a real person. Fax: 1-858-303-9049 year in a row. Provider Relations Phone Number. Arizona state law and your Mercy Care provider contract prohibits balance billing MC members for Medicaid covered services and benefits. Manage your claims. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. Sharp Health Plan is accepting enrollments all year, thanks to the 5-star special enrollment period. http://oig.hhs.gov/fraud/report-fraud/index.asp. [SBM Sharp Health Plan [ 1-800-359-2002. Non-contracted providers can refer to the AHCCCS fee schedule for reimbursement information. REDUCE RISK , Learn how to reduce colon cancer risk by making healthy lifestyle changes. Sharp Health Plan . *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.