The Provider Manual was developed for Samaritan Health Plan Operations’ contracted providers to use as a tool in the delivery of healthcare to our members. This document should be used in conjunction with your contract with any of the following: Samaritan Health Plans, InterCommunity Health Plans or Samaritan Health Services (SHS). Provider Manual (Updated June 30, 2023)
For those provider partners not yet familiar with our provider portal, Provider Connect, we have put together a tutorial to help you sign up and navigate.
Provider Connect Tutorial
Utilization management (UM) is integrated within the Medical Management care management program. This handbook is designed to assist in understanding the prior authorization review process: types of reviews performed, specific criteria applied, notification process, etc. Please access this handbook for more information and step-by-step instructions for submitting online prior authorization requests.Utilization Management & Service Authorization Handbook
Samaritan Health Plans and Specialty Fusion manages authorization requests for all outpatient provider-administered specialty and oncology drugs made on behalf of members. Visit the Specialty Fusion portal to submit and track your requests online. For instructions on how to navigate the Specialty Fusion prior authorization portal, please read the Specialty Fusion user guide .
Select “Leave Site” to go to the external website.