Sharp Health Plan

Summary

Sharp Health Plan is a regional health plan, part of Sharp HealthCare, offering medical coverage operating in California. Claims route under payer ID SCMG1, with 2 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through Sharp Health Plan Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID

SCMG1Also seen as 7225, 8642

Also known as

Sharp Community Medical Group

Uses CAQH

YesApplication route: Payer portal application

Service area

CA (San Diego County)

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

Common questions

What is the payer ID for Sharp Health Plan?

The payer ID for Sharp Health Plan is SCMG1. Alternate IDs seen across clearinghouses include 7225, 8642.

How long does Sharp Health Plan provider enrollment take?

Sharp Health Plan provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Sharp Health Plan require CAQH?

Yes. Sharp Health Plan uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.

Does Sharp Health Plan require ERA enrollment?

Yes. Sharp Health Plan requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.

What states does Sharp Health Plan cover?

Sharp Health Plan operates in CA (San Diego County). Coverage can differ by plan and product line, so confirm the specific plan before you file.

Related payers