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Sanford Health Plan

Provider Satisfaction Survey results

Sanford Health Plan conducts an annual practitioner satisfaction survey. Below are those survey results related to satisfaction with the Utilization Management process and continuity and coordination of care among providers.

2016 Practitioner Satisfaction Survey 2016 2015 2014
UM Process Satisfaction: (% Very Satisfied/Satisfied)
Ease of prior authorization process 87.9% 84.2% 83.4%
Timeliness of UM decisions 81.7% 83.7% >89.8%
Overall satisfaction with Utilization Management process 86.4% 83.4% 87.8%
Like to see more info on what requires prior authorization (% Yes) 51.5% 53.3% 52.6%
Coordination of Care Among Providers:
Out of the patients you refer to other providers, how many of those referred providers send back clinical information about your patients? (% Responding Some) 66.7% 60.6% 70.7%
Out of the patients you refer to other providers, how many of those referred providers send back clinical information about your patients? (% Responding Every) 18.3% 32.7% 24.4%
Out of the patients you refer to other providers, how many of those providers do you send the patient’s clinical information to? (% Responding Some) 32% 36.0% 35.1%
Out of the patients you refer to other providers, how many of those providers do you send the patient’s clinical information to? (% Responding Every) 52% 53.4% 14.7%
Have you ever been notified by a behavioral health provider that one of your patients is receiving behavioral health care services? (% Responding Yes) 19.6% 21.4% 24.6%
Of the behavioral health providers who have informed you about your patients receiving behavioral health care services, to what degree do you consult with each other regarding patients’…(% Responding Always or Usually)
Diagnosis 48.1% 30.4% 26.9%
Treatment Plans 59.3% 29.8% 27.6%
Medications 50% 31.0% 29.8%

 

 

Related to the Utilization Management process, the Plan has, and will continue to, provide ongoing member and provider education on what prior authorization is, what services require prior authorization and what the process is for requesting prior authorization. This information is also available on our website at sanfordhealthplan.com or by calling our Utilization Management Department at (605) 328-6807 or (800) 805-7938.

As you know, communication between primary care physicians and specialists, including behavioral health specialists, is crucial to the over-all care of patients. Sanford Health Plan’s goal is to ensure that our members receive seamless, continuous and appropriate care regarding diagnosis, medication and treatment plans whether in an inpatient or outpatient setting. Coordination of care is essential to promote safe, proper and unduplicated health care services. In an effort to foster coordinated care, we ask that you remember these important aspects of coordination of care:

  • Systematically send relevant clinical information in a timely manner to the practitioner the patient is being referred to or has been referred from.
    • Diabetic patients: Provide annual eye exam results to the PCP or request results from the optometrist/ ophthalmologist
    • Cardiac patients: Ensure patient has a lipid panel ordered annually by either the PCP or Cardiologist
    • All patients: Communicate any changes in the treatment plan to all members of the patient care team
  • Review clinical information in a timely manner and determine if further contact is needed to initiate additional care/visits.
  • Contact patients after discharge from a facility and coordinate follow-up care with the patient and/or family.
  • For patients transitioning to another level of care, develop a transition plan with the patient and/or family.
  • A Primary Care Provider (PCP) should oversee all general medical health care for a patient.
    • Obtain documentation of testing and consults from referral providers.
    • Review the patient medication list during each office visit.
    • When consultants or specialists are involved in the care of the patient, ensure the health care team is communicating so that all important tests and other elements of care are completed.
  • Using your state’s Immunization Registry for an easy way to communicate with fellow practitioners as to what immunizations your patients have received. This can be used to fill in the blanks when a patient has emergent care or moves out of your city to a new provider. It can also be used when you are receiving a new patient that has no personal record of their vaccinations. Your office can obtain a login through your State Department of Health.
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Insurance terms are confusing. Let us help make sense of it all.

Purchasing through Sanford Health Plan or the Marketplace, let us explain the differences

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Tell Us About Yourself

Insurance terms are confusing. Let us help make sense of it all.

Purchasing through Sanford Health Plan or the Marketplace, let us explain the differences

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