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Electronic Data Interchange

Welcome

Sanford Health Plan encourages the use of EDI transactions to increase efficiency and reduce errors. Sanford Health Plan will accept 837 compliant claim transactions meeting our Companion Guide criteria. Companion Guides are available for download below:

Trading Partner Agreement (TPA)

EDI Trading Partners

To discuss direct claim submittal or for general questions please contact: 

Please contact these clearinghouse(s) directly for more information on submitting electronic claims via their services.

EFT and 835 ERA

Sanford Health Plan Contracts with Emdeon to Deliver EFT and 835 ERAS!

As changing market dynamics continue to increase the pressure to maximize revenue and profit, providers and healthcare systems are searching for ways to reduce costs while increasing efficiency across the billing cycle. To that end, we are pleased to announce that Sanford Health Plan has arranged for Emdeon to deliver ePayment services, consisting of electronic funds transfer (EFT) and electronic remittance advice (ERA) transactions in the postable 835 format.

Harness the power of electronic remittances
Emdeon provides payer remittance data electronically via Emdeon Payment Manager, which is offered as a complimentary service with EFT enrollment. You will continue to receive paper remittances for 45 days after EFT enrollment. At this time paper remittances will no longer be sent. However, these documents will continue to be available electronically through Payment Manager. With Payment Manager, staff can quickly search, view or print each remittance as needed.

Simple enrollment. Incredible benefits.
We invite you to enroll today to begin taking advantage of electronic payments and remittance statements that may be already available from your other payers (see a full list of payers by visiting the link provided at the end of this letter).
 
Enrollment for Emdeon ePayment is a fast, one-time process. Simply follow the instructions outlined below to begin receiving electronic payments and remittance advices today!
 
 

myHealthPlan for Providers

On-Line Access to Member Benefits, EOPS, Submit Prior Authorizations and more....

myHealthPlan is Sanford Health Plan's online benefits tool available to Providers. Through this online tool, we are able to offer you more streamlined services and access to information any time of day all at your fingertips. We recognize our provider network is vital to the quality service we promise our members. Therefore, Sanford Health Plan is committed to providing you with the online tools you need to process claims, manage member information and improve your administrative efficiency. Please encourage members of your staff to sign up for an account and begin taking advantage of the benefits myHealthPlan can provide.

With myHealthPlan you will enjoy these features:

  • View benefits accumulators for members - deductibles, coinsurance and out-of-pocket expense totals at a glance.
  • Verify up to two years of member eligibility information
  • View check numbers to track payment - identify if a check has posted or cleared.
  • Register under multiple Tax Ids and NPI Numbers - access information for multiple billing entities.
  • Email Express Requests to Provider Relations, Member Services and Utilization Management for Prior Authorization requests.
  • View Provider Resources including forms, the Manual and its Policies

To register for myHealthPlan click on myHealthPlan. This will transport you to the login page where you can sign up for a Provider account.

If there is anything you would like to see added to myHealthPlan, please let your Provider Relations Representative know or email us at ppr@sanfordhealth.org