Sanford Health Plan

Summary

Sanford Health Plan is a regional health plan, part of Sanford Health, offering medical coverage operating in 4 states. Claims route under payer ID 91184, with 5 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through Sanford Health Plan Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and activates within hours.

At a glance

Payer ID

91184Also seen as 10533, 2116, 5961, 91184MC, MNSHP

Uses CAQH

YesApplication route: CAQH application only

Service area

IA, MN, ND, SD

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

Common questions

What is the payer ID for Sanford Health Plan?

The payer ID for Sanford Health Plan is 91184. Alternate IDs seen across clearinghouses include 10533, 2116, 5961, 91184MC.

How long does Sanford Health Plan provider enrollment take?

Sanford Health Plan provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Sanford Health Plan require CAQH?

Yes. Sanford Health Plan uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.

Does Sanford Health Plan require ERA enrollment?

Yes. Sanford Health Plan requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few hours.

What states does Sanford Health Plan cover?

Sanford Health Plan operates in IA, MN, ND, SD. Coverage can differ by plan and product line, so confirm the specific plan before you file.