Clinical resources

Sharp Health Plan has gathered a library of clinical guidelines and health resources to make delivering quality care easier than ever.

Prior Authorization Guide for independent providers

Use this helpful guide to determine when prior authorization is required for a particular service.

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Prior Authorization Quick Reference Guide for independent providers

Not sure if a member needs a referral, authorization, or notification prior to receiving care? Use this guide to quickly find out whether you need to fill out forms and how to submit them.

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Clinical practice guidelines

We’ve adopted a series of guidelines to help your team improve your patients' health.

SEE GUIDELINES ➜

USPSTF Preventive Services Recommendations

Get the U.S. Preventive Services Task Force’s independent advice for how often members should receive preventive care.

READ RECOMMENDATIONS ➜

AAP Guidelines for Perinatal Care

Find out the American Academy of Pediatrics’ and American Congress of Obstetrician and Gynecologists’ most recent recommendations on quality care for pregnant women and their babies.

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Vaccine recommendations

See which vaccines the Advisory Committee for Immunization Practices (ACIP) recommends for members based on their age and other characteristics.

VIEW RECOMMENDATIONS ➜

Mental 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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Acupuncture and chiropractic services

Find out how members can access acupuncture or chiropractic services.

GET THE DETAILS ➜

Timely access to care standards

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

SEE STANDARDS ➜

Outpatient prescription drugs

Learn how to help members get covered outpatient prescription drugs from local, Sharp Health Plan-contracted pharmacies.

SEE MORE INFORMATION ➜

Medical benefit policy

We routinely review the most current, published medical evidence and the U.S. Preventive Services Task Force recommendations. Take a look at Sharp Health Plan's preventive health services medical benefit policy for all ages.

DOWNLOAD POLICY ➜

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