Medical Management
Precertification is the process of confirming that a patient is eligible on a benefit plan to be covered by the payer and to collect information prior to the admission or service. This process should inform all parties in advance of treatment; identify patient for pre-service discharge planning and register patients for Case Management and Disease Management when needed.
SHARP provides precertification services as required by the plan for the following employer plans and insurance companies. Please complete a SHARP Precertification Request Form and fax to SHARP’s confidential fax number (870) 972-0036.
- Arkansas Methodist Medical Center: All Inpatient Services, Outpatient Surgery, CT, MRI, PET Scans
- Lawrence Health Services: All Inpatient Services, Mental Health Treatment, Transplant Services, Ultrasounds for Pregnancy, Prenatal/Maternity Care, Home Health Care, Home Infusion, Hospice Care, DME over $500, Diabetic Teaching, PET Scans, Nuclear Medicine. Imaging Services - SHARP provides precert services for Lawrence Health Group's imaging services.
- St. Bernards Medical Center: All Inpatient Services, Outpatient Surgery, CT, MRI, PET Scans **Private Duty Nursing Services (must be pre-authorized through TPA before services are rendered) Insulin pumps must have a prior-authorization with SHARP prior to services rendered, DME over $500
- St. Bernards Owned Clinics Group.: All Inpatient Services, Outpatient Surgery, CT, MRI, PET Scans **Private Duty Nursing Services (must be pre-authorized through TPA before services are rendered), DME over $500
- St. Bernards Five Rivers: All Inpatient Admissions, Outpatient Procedures (surgeries, CT Scans, PET Scans, MRIs, Diagnostic testing), All therapies (PT, OT, Speech), DME over $500
Case Management is a collaborative process of assessing, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality, cost-effective outcomes.
We provide case management for patients with potentially catastrophic illnesses, for example, high-risk pregnancies, or acute illnesses such as cancer. Case management can also be useful for patients with managing chronic disease such as diabetes. The case management process should inform all parties of insurance coverage and benefits, coordinate the services associated with discharge or return home, provide patient education, determine rates with providers who are out of network, and coordinate services with other healthcare providers.
SHARP currently provides case management services for the following health plans:
- Arkansas Glass Container Corporation
- Arkansas Methodist Medical Center
- Craighead County
- Lawrence Health Services
- St. Bernards Medical Center
- St. Bernards Owned Clinics Group
- St. Bernards Five Rivers
- Narcotic abuse is not only harmful to members but also costly to employers. Paying for unneeded medication is not fair to the employer or the workforce. Patient safety, unnecessary medication and higher cost are concerns with unchecked narcotic use. Our review is conducted by a Board Certified Physician. We have the expertise to make it happen in a confidential, easy manner.
St. Bernards Medical Center and St. Bernards Clinic employees/dependants can download the required forms and fax to (870) 972-0036.
SHARP provides referral management services as required by the plan for the following employer plans and insurance companies. If you have a patient covered with one of these groups that needs a referral for the services listed for that group please complete a SHARP Patient Referral Form and fax to SHARP’s confidential fax number (870) 972-0036.
Arkansas Glass - SHARP Tertiary Providers, Out of Network Requests
Arkansas Methodist Medical Center - SHARP Tertiary Providers, Out of Network Requests
Lawrence Health Systems - SHARP Tertiary Providers, Out of Network Requests
St. Bernards Medical Center - SHARP Tertiary Providers, Out of Network Requests
St. Bernards Owned Clinics Group - SHARP Tertiary Providers, Out of Network Requests
St. Bernards Five Rivers - SHARP Tertiary Providers
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