Clinical resources

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

Medical prior authorization

Our prior authorization guide makes it easy to determine when prior authorization is required for a particular service. Note that these guidelines are specific to services for members enrolled in an HMO plan and assigned to providers who are independently contracted with us.

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Medical prior auth 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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Pharmacy prior authorization

If you would like to prescribe a medication that requires authorization, you’ll need to fill out the prior authorization request form and give us any relevant support or documentation. Once the form is complete, we can review your request.

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Behavioral health prior authorization

See what behavioral health and chemical dependency services require prior authorization for our commercial plan members.

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Clinical practice guidelines

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

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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.

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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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Acupuncture and chiropractic services

Find out how members can access acupuncture or chiropractic services through American Specialty Health.

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Timely access to care

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

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Outpatient prescription drugs

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

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