Precertification Request

SHARP provides precertification 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 is needing the service listed for that group please complete a SHARP Precertification Request Form and fax to SHARP’s confidential fax number (870) 972-0036. SHARP currently utilizes InterQual clinical criteria when providing precertification services.

  • Arkansas Methodist Medical Center: All Inpatient Services, Outpatient Surgery, CT, MRI, PET Scans
  • Lawrence Health Services: All Inpatient Services, Outpatient Surgeries, Mental Health Treatment, Transplant Services, Ultrasounds for Pregnancy, Prenatal/Maternity Care, Home Health Care, Home Infusion, Hospice Care, DME over $500, Insulin pumps, Diabetic Teaching, PET Scans, Nuclear Medicine. Imaging Services - SHARP provides precertification services for Lawrence Health Group's imaging services.
  • St. Bernards Medical Center: All Inpatient Services, Outpatient Surgery, CT, MRI, PET Scans , **insulin pumps **Private Duty Nursing Services (**must be pre-authorized before services are rendered), DME over $500
  • St. Bernards Medical Practices: All Inpatient Services, Outpatient Surgery, CT, MRI, PET Scans **Private Duty Nursing Services (must be pre-authorized before services are rendered), DME over $500, Insulin pumps
  • St. Bernards Five Rivers: All Inpatient Services, Outpatient Procedures (surgeries, CT Scans, PET Scans, MRIs, Diagnostic testing), All therapies (PT, OT, Speech), DME over $500, Home Health Care, Hospice Care

Download the Form

Fill out and return this form to request precertification for your patient's medical service.
Precertification Form [DOC]