Provider Resources
Your hub for working with Sana — verify benefits, submit claims, request authorizations, manage credentialing, and reach our support team. Everything your practice needs, in one place. No login required.
Find what you need.
Sana details at a glance.
Everything you need to identify Sana for claims, eligibility, and support — in one place.
Verify coverage before you provide care.
Through our partnership with Stedi, you can verify member eligibility, benefits, and claim status. There are three ways to check:
Option 1 · Electronically through your EMR
Verify instantly through most EMR and medical record systems using our Payer ID SANA1.
Option 2 · Stedi portal
Sign up at stedi.com and use the Stedi portal to check eligibility electronically.
Option 3 · Live secure chat
Prefer to talk it through? Click the chat icon on this page to reach Provider Support, available 24/7. When you start a chat, have this ready:
- Patient name
- Patient date of birth
- Member ID number
- Provider office NPI number
For prior authorization (pre-certification), call our utilization management partner, Valenz, at (877) 608-2200.
Reading a Sana ID card
Here’s where the details you’ll need live on a Sana member ID card:
Sample cards for reference — actual member details will vary.
Submitting, checking status, and getting paid.
How to submit a claim
Electronic (recommended): submit using Payer ID 50114.
Paper: Sana accepts UB-04 or CMS-1500 standard claim forms, mailed to:
P.O. Box 855
Arnold, MD 21012
Timely filing
Submit clean claims within 180 days from the last date of service (unless your contract specifies otherwise).
How Sana pays
Most clean claims are processed and paid within 7.5 business days; some can take up to 60 business days depending on contract language. Payments are distributed by ECHO Health, which also delivers your Explanation of Provider Payment (EPP) and 1099 forms.
Checking claim status
Fastest through your EMR using Payer ID SANA1, or via secure chat. Have ready: provider name, NPI number, member name, member DOB, and date of service.
Payment options & management
- Virtual Card / VCard (default) — manage at echovcards.com; opt out via QuicRemit at (877) 705-4230
- ACH Direct Deposit — enroll and validate through ECHO
- MedPay (MPX) — EFT or print checks in-office at echochecks.com
- Paper check — traditional USPS delivery
Use ECHO’s provider payment portal at providerpayments.com to retrieve EPPs, EDI files, and check settlement status. Reach ECHO directly at (888) 834-3511, option 1.
Pre-certification & what needs it.
Sana partners with Valenz (URAC-accredited) for utilization management. Two ways to request pre-certification:
- By phone: call Valenz at (877) 608-2200
- Online: use the Valenz portal — select “I am a provider,” request type “Precertification Request,” choose inpatient or outpatient, complete all fields, and attach clinical files
Standard prior-authorization reviews typically complete around 15 days after medical records are received. To verify patient benefits, use the secure chat on this page.
Services requiring pre-certification
- Inpatient hospitalization
- Outpatient surgery (hospital or ASC)
- Inpatient and outpatient hospice
- Cardiac rehab
- Respiratory therapy
- CT scan, MRI, MRA, PET scan, bone scan
- Pain management epidural steroid injections
- Pain management radiofrequency ablation / rhizotomy
- Pain management trigger point or facet injections
- Arteriograms & angiograms (other than heart)
- Dialysis
- Intensive outpatient substance abuse
- Home health care
- Speech therapy
- Infusion therapy (excl. antibiotic infusion)
- Specialty injectable medications
- DME (rental > 2 months, or purchase > $1,000 per date of service)
- In-vitro fertilization (IVF)
- Mental health at a residential treatment facility, partial hospitalization, or intensive outpatient setting
- Radiation therapy
- Participation in an approved clinical trial
Emergency & urgent admissions do not require prior approval. Notify the pre-cert department within 24 hours (weekday admission) or 72 hours / by the first business day (after-hours, weekend, or holiday). Pre-certification approval alone does not verify eligibility or guarantee payment.
Levels, deadlines, and where to send them.
Sana offers two internal levels of appeal. After internal appeals are exhausted, an external review by an independent review organization (IRO) may be available for eligible adverse determinations involving medical judgment or a rescission of coverage.
Filing deadlines
- Initial appeal: within 180 days of the adverse benefit determination
- Second-level appeal: within 60 days of the first-level determination
- External review: within 4 months of the second-level determination
Where to submit
Appeals must be made in writing. To file any appeal in writing, address it as follows:
Attn: Appeals
3723 Greenville Ave STE 13463
Dallas, TX 75206
Pharmacy appeals go to SmithRx (see Pharmacy). Include the member name, member ID or SSN, group name/ID, the facts supporting the claim, and a clear statement of the reason for disagreement.
Prescriptions, formulary & SmithRx.
Sana partners with SmithRx to administer drug coverage across all plans, including the nationwide pharmacy network, formulary, adjudication, utilization management, and pharmacy appeals.
The formulary changes regularly — always confirm current coverage before prescribing. View the current SmithRx formulary, or contact SmithRx to confirm patient eligibility, pharmacy benefits, and formulary coverage.
Member line: (844) 454-5201 · Provider line: (844) 512-3030
Fax: (866) 642-5620 · Website: mysmithrx.com
Note: RxBIN / RxPCN / RxGRP are printed on each member’s ID card, as they vary by group and member.
Licenses & roster updates.
Maintaining your credentials
Providers must maintain current, valid, and unrestricted professional licenses and certifications, and satisfy Sana’s credentialing requirements. Notify Sana within 48 hours if any license or certification becomes suspended, limited, terminated, or excluded under a federal or other government program.
Roster updates
To add or remove a provider, or update practice or location information, submit a roster update using our roster update form.
Need a hand? We’re here.
Reach our top-rated provider support team the way that works best for you — real-time secure chat, a support request to our Network Operations team, or the Help Center.
Secure chat
The fastest way to check eligibility, benefits, and claim status in real time. Click the chat icon in the bottom-right corner of this page to start.
Submit a support request
For network operations help, send a Network Operations Request and our team will follow up shortly.
Submit a support requestHelp Center
Browse provider articles on claims, eligibility, authorizations, and more in Sana’s Help Center.
Visit the Help CenterThe full Sana Provider Manual
Want every detail? The complete manual covers plans, claims, payments, appeals, pre-certification, pharmacy, and reimbursement. Version 4.0.0 · June 2025.