Dear Valued Clients,

This fall, Sanford Health Plan will be sending a letter to subscribers that reminds them how to find in-network providers and facilities, so their claims are processed accurately. This includes directing them to the Provider Directory, which is undergoing updates to make it more user-friendly. The enhanced Provider Directory will help to ensure understanding and use pertaining to available providers and care options. The updates to the Directory will be available on January 1, 2023.

Action will be required for subscribers and/or dependents who reside outside of the Sanford Health Plan Service Area. They are being asked to submit an Out-Of-Area Verification Form by December 1, 2022, to ensure their claims are processed as in-network.

What To Know:

• Members who reside inside the Sanford Health Plan Service Area (defined below) will continue to have access to in-network urgent/emergent services while outside the service area. The urgent care directory will be available to access via a link within the Provider Directory.
• Members/dependents who reside outside the Sanford Health Plan Service Area will be asked to submit an Out-Of-Area Verification Form by December 1, 2022, to ensure their claims are processed accurately. These members will have access to Multiplan’s nationwide network of providers and facilities, and they will see MultiPlan providers when they log into the Provider Directory.

The Sanford Health Plan service area is defined as follows:

• SOUTH DAKOTA- all counties in the state
• NORTH DAKOTA- all counties in the state
• IOWA- Clay, Dickinson, Emmet, Ida, Lyon, O’Brien, Osceola, Plymouth, Sioux and Woodbury counties
• MINNESOTA- Becker, Beltrami, Big Stone, Blue Earth, Brown, Chippewa, Clay, Clearwater, Cottonwood, Douglas, Grant, Hubbard, Lake of the Woods, Lincoln, Lyon, Mahnomen, Marshall, Martin, McLeod, Meeker, Murray, Nicollet, Nobles, Norman, Otter Tail, Pennington, Pipestone, Polk, Pope, Red Lake, Redwood, Renville, Rock, Roseau, Sibley, Stearns, Stevens, Swift, Traverse, Wilkin, Watonwan and Yellow Medicine counties

If members plan to receive services outside the service area that require a prior authorization, they should be sure to have the prior authorization on file with us before they leave. Additional details on prior authorizations can be found by visiting our website, sanfordhealthplan.com/members/prior-authorization.

Please contact your broker with any questions, or you can reach out to our team at (888) 535-4831 or by emailing sales@sanfordhealthplan.com.

Thank you,

Sanford Health Plan