Commercial provider forms

Find all the documents you need at the moment you need them with this handy library of forms and resources.

Find forms and documents for you and your patients below including authorizations and referrals, medical, claim forms, and others you may need to manage your practice and care for your patients.

Select a category from the list below to view and download the forms you need.

 
Authorizations and referrals

  • Behavioral health prior authorization request form
  • Use this form to submit a prior authorization request for any mental health or substance use disorder services.
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  • file icon  English (PDF)

  • Point-of-service (POS) precertification form
  • Use this form to request pre-certification for a Sharp Health Plan POS member to receive health services from an out-of-network provider.
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  • file icon English (PDF)

  • Prescription drug prior authorization or step therapy execution request
  • Use this form to submit a prior authorization request for medications or step therapy.
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  • file icon English (PDF)

  • Referral & prior authorization request form
  • If a service requires prior authorization, use this form to submit a request to receive approval before scheduling a procedure. Providers who are rendering care to members assigned to a plan medical group (PMG) should contact the PMG for prior authorization.
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  • file icon  English (PDF)


 
Care management

  • Case management and disease management referral form
  • Use this form to refer a member to a case management or disease management program.
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  • file icon  English (PDF)

  • Member dismissal request form
  • Use this form to request dismissal of a current member assigned under a Sharp Health Plan policy from your care.
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  • file icon  English (PDF)


 
Claims and payments

  • EDI / ERA enrollment form
  • Use this form to submit a request to enroll in electronic data interchange (EDI) for claims submission and electronic remittance advice (ERA) in place of paper evidence of benefits (EOBs) and checks.
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  • Online form external link icon | file icon  English (PDF)

  • Member reimbursement request form - medical services
  • This form is for members who wish to request a refund form Sharp Health Plan for the cost of approved medical services. This form must be submitted directly by the member.
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  • file icon  English (PDF)

  • Provider dispute resolution request form
  • Use this form to dispute any payments or denials that have been processed by Sharp Health Plan.
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  • file icon  English (PDF)


 
Grievances and appeals

  • Member grievance & appeal form
  • Members can use this form to file a grievance or appeal with Sharp Health Plan or a plan provider.
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  • Online form external link icon  |  file icon English (PDF) | file icon Spanish (PDF)

  • Cancellation of health care coverage grievance form
  • Members can use this form to file a grievance regarding the cancellation, rescission, or nonrenewal of their health care coverage to the Department of Managed Health Care (DMHC).
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  • Online form external link icon  |  file icon English (PDF)


 
Provider information

  • Update my profile information
  • Log in to your Sharp Connect account to update your provider profile information such as your status, email, and office locations.
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  • Online form external link icon


Looking for Medicare provider forms?

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