Medical prior authorization

Services that require precertification for members enrolled in benefits through our point of service (POS) or preferred provider organization (PPO) click here.

Our prior authorization guide makes it easier to determine when prior authorization is required for a particular service. Note that these guidelines are specific to services for members enrolled in HMO plan and assigned to providers who are independently contracted with Sharp Health Plan. For members assigned to a different plan medical group (PMG), providers should contact the PMG directly for details and their referral and authorization processes. The PMG is identified on the member's identification card.

VIEW/DOWNLOAD MEDICAL PRIOR AUTHORIZATION GUIDE

Fill out a prior authorization form

• Please complete authorization request via Provider Portal (if access available)
  • https://www.sharphealthplan.com/login
• If not, please complete the appropriate prior authorization form in its entirety.
  • Incomplete forms will be faxed back to sender.
  • Fax completed form to 1-619-740-8111 
• Be sure to include any clinical documentation to support your authorization request. Include anything that may be important to review such as chart notes, imaging, or lab data. The more information you provide, the better we can fulfill your request.

Have a question?

• Call Customer Care at 1-858-499-8300
  • Toll free 1-800-359-2002 
  • Dedicated provider line 1-844-483-9012
• Email us at customer.service@sharp.com
• Available Monday through Friday between 8 am and 6 pm

Behavioral Health questions?

• Magellan 1-866-512-6190
• Provider Hub – https://www.magellanProvider.com/SharpHP