Second pass claim edits implemented
Posted: 2/2/2026
Sanford Health Plan regularly updates, modifies and enhances its claim system to ensure appropriate and accurate payments.
As of Feb. 3, 2026, we implemented an additional claim editing system to ensure we follow current published reimbursement policies and validate correct coding guidelines as documented in CPT, HCPCS Level II, ICD-9 and ICD-10 as well as generally accepted billing guidelines. This change, which we notified you of in September 2025, will help provide greater focus on identifying incorrect, inappropriate or duplicative services and/or payments.
The list of edits is available on the website under “provider forms.”
Please share this information with your teams. We will continue to share updates in our Fast Facts newsletter and on our website in the “Fast Facts” section.
As of Feb. 3, 2026, we implemented an additional claim editing system to ensure we follow current published reimbursement policies and validate correct coding guidelines as documented in CPT, HCPCS Level II, ICD-9 and ICD-10 as well as generally accepted billing guidelines. This change, which we notified you of in September 2025, will help provide greater focus on identifying incorrect, inappropriate or duplicative services and/or payments.
The list of edits is available on the website under “provider forms.”
Please share this information with your teams. We will continue to share updates in our Fast Facts newsletter and on our website in the “Fast Facts” section.