Section 8: Online Tools, Publications & Forms

8.1 mySanfordHealthPlan Provider Portal

mySanfordHealthPlan provider portal is Sanford Health Plan’s online portal available to providers. Through this secure online tool, you have access to information 24/7. With mySanfordHealthPlan provider portal you will be able to:

  • Request prior authorizations
  • View copay, deductibles, coinsurance and out-of-pocket totals for members
  • Verify member eligibility and view covered family member(s)
  • Submit medical and pharmacy prior authorizations and online claim reconsiderations
  • Access the provider manual and policies
  • Check status of claims 
  • Obtain copies of Explanation of Payments

To request a mySanfordHealthPlan provider portal account, follow these steps:

  1. Go to sanfordhealth.org/Provider
  2. Click on “Request Access”
  3. Enter all the required account information on the following screens, then click “Finish” Your information will then be submitted to be reviewed for approval. Once your account has been approved you will receive an email from Sanford Health Plan Provider Relations. Afterward, you will be able to log on to your provider account using the User ID and Password you created upon setting up your account.

If you have any questions or need assistance with setting up an account, please contact Provider Relations at (605) 328-6877 or (800) 601-5086. Choose option 2 and then option 4. You can also send an email to providerrelations@sanfordhealth.org.

8.1.1 How to Request Prior Authorization

How to request Prior Authorization
Prior authorizations for health care services should be obtained online by logging in to the mySanfordHealthPlan provider portal at sanfordhealth.org/Provider. Open the member record and choose “Create Referral”. The tutorial explaining how to request a prior authorization is located within the provider portal. NOTE: Oncology treatment and services must be entered and authorized through eviti|Connect online at eviti.com. High-end imaging services for select members and health plans must be entered and authorized through eviCore at evicore.com.

To reach our UM department please call (800) 805-7938 and follow the appropriate menu prompts. Team members are available 8 a.m. to 5 p.m. CST, Monday through Friday.

After hours, you may leave a message on the confidential voice mail and someone will return your call the following business day.

A list of services requiring prior authorization can be found online at sanfordhealthplan.com/priorauthorization.

8.2 Provider Directory

You can access the provider directory on our site sanfordhealthplan.com or through mySanfordHealthPlan under Eligibility & Benefits:

  • Go to www3.viiad.com/shp/public 
  • Access the member login section on the right side of the page
  • Enter member ID and last name

8.3 Forms

For your convenience, you will find our forms posted outside the secure login of mySanfordHealthPlan for providers. Some of our commonly used forms include: Claim Reconsideration Form, credentialing applications for providers, Provider Information Update/ ChangeForm, Health Management Referral Form and more. To access a form, CLICK HERE.

8.4 Sanford Health Plan ID Card & Benefit Card

What do our ID cards look like? The answer depends on our products and services. We created a document that gives you a high level overview of our ID cards and basic information. To view or print a sample CLICK HERE.

The Benefit Card is a special purpose Visa® card that gives members an easy, automatic way to pay for eligible healthcare expenses. The card is given to members who sign up for a medical FSA (Flexible Spending Account), Health Reimbursement Account (HRA) or Health Savings Account (HSA). To view or print a sample CLICK HERE.

8.5 Provider Newsletters

The Provider Perspective and Fast Facts are electronic newsletters for providers and their office staff. With each newsletter, we share information about a variety of topics to keep you up-to-date. You can view past issues or sign up to receive the newsletter on our provider website, CLICK HERE.