Providers are the heart of Sharp

Here you’ll find the tools and support you need to be there for your patients when they need it most.

With our providers, patients and health plans working together, we can ensure the best possible outcome every time. For eligibility, referrals, claims, credentialing, contracting, assistance with your Sharp Health Plan online account or any other provider-related matter, email us at provider.relations@sharp.com or call 1-858-499-8330. Our fax number is 1-858-303-9049.

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Submit your claims online

Submitting claims online can reduce errors, resulting in quicker processing and payment.

HOW TO SUBMIT CLAIMS ONLINE

Sign up for a Sharp Health Plan account

Check eligibility, view claims statuses and more. Contact your designated site administrator to get registered.

News and alerts

We serve up the latest Sharp Health Plan news for you so that you can better serve your patients.

TAKE ME THERE ➜

Submitting claims

Find out how to submit claims and make processing and settling claims easier for you and your patients.

HOW TO SUBMIT CLAIMS ➜

Check eligibility

Submit bulk patient eligibility requests through your Sharp Health Plan online account or use our phone self-service tool for single patient verifications.

LOG IN ➜

Are you looking for our medical and pharmacy policies and procedures? They're located on our provider portal.

Utilization management

Here are the guides, manuals and resources you need to request prior authorization, make a referral and access Sharp’s medical policies.

ACCESS UTILIZATION MANAGEMENT GUIDELINES ➜

Prior authorization

Check our prior authorization guidelines for covered procedures, services and medications before you perform a service or prescribe.

FIND OUT MORE ➜

Prescriptions and medications

Search the covered drug and specialty drug lists, download prior authorization request forms, and find pharmacy benefit resources, all in one place.

MANAGING PRESCRIPTIONS ➜

Behavioral health services

Learn how to help members get access to the services they need for diagnosis and treatment of behavioral health conditions.

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Electronic prescribing mandate information

Effective January 1, 2022, all California health care practitioners who are authorized to prescribe will be required to issue prescriptions electronically.

READ MORE

Provider Operations Manuals

Our Provider Operations Manuals show the benefits we offer, a list of provider responsibilities and efforts towards quality improvement.

DOWNLOAD MANUALS ➜

Commercial provider forms

Browse, download, and print enrollment forms, authorization request, appeal requests, and other useful documents.

DOWNLOAD FORMS ➜

Medicare provider forms

You can find Medicare forms and authorizations on the Sharp Direct Advantage website.

ACCESS MEDICARE FORMS AND AUTHORIZATIONS ➜

Timely access to care

Get helpful reminders about how to comply with the timely access laws, which outline maximum wait times for phone calls and appointment requests.

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Language assistance program

Quality care depends on clear communication between you and your patients. Get the right support so that no questions are left unanswered.

ACCESS LANGUAGE ASSISTANCE PROGRAM
 

Coronavirus & COVID-19 resources for providers

Stay up-to-date on Sharp Health Plan-related information related to coronavirus and COVID-19.

Quality improvement

Find the programs in place to help keep your patients safe and the resources available that support quality care.

EXPLORE QUALITY IMPROVEMENT EFFORTS ➜

Clinical resources

Use our library of clinical resources to save time, diagnose and treat members even more effectively, and make the member experience the best it can be.

ACCESS CLINICAL RESOURCES ➜

Become a contracted provider

We wouldn't be here without the passion and skill of providers just like you. Enrollment starts here, and we'd love to partner with you.

LEARN ABOUT ENROLLMENT ➜

Language assistance program

Quality care depends on clear communication between you and your patients. Get the right support so that no questions are left unanswered.

INTERPRETATION SERVICES ➜

Training

At Sharp, Health Equity and Cultural Humility are important to us. If you’d like to know more about integrating cultural humility into your office or practice, here’s a great resource for you to use.

ACCESS CULTURAL HUMILITY RESOURCES ➜
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Learn how you can help your patients through the Shingrix shortage.

Read the update ➜

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Share details about hepatitis B and hepatitis C to help our members stay informed.

Learn more ➜

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Help educate our members on the importance of getting recommended vaccines.

View recommendations ➜

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Share these warning signs of suicide and how to find support.

Know the signs ➜

"We are thrilled with the support that we receive at all levels. All of the points of contact are professional, committed and passionate about providing high-quality service."

- Sherri R., Director of Benefits & HR Information Systems, Palomar Health