Provider Portal
With the Sutter Health Plan Provider Portal, network providers can check member eligibility, view claims and access valuable resources with ease.
The Provider Portal is your round-the-clock solution for efficient member health benefits management.
Eligibility verification
Access member coverage information
Search claims
Download forms and resources
Read the provider manual
How to Register
Register for the Provider Portal to make managing member coverage with Sutter Health Plan easy.
- Step 1: Go to shplan.org/providerportal and select “Register Here.”
- Step 2: Carefully review and then accept the “Provider Responsibilities” related to accessing Protected Health Information (PHI).
- Step 3: Follow the instructions to complete all required sections on the Provider Registration Page. You’ll need your license number, National Provider Identifier (NPI) and Taxpayer Identification Number (TIN).
- Step 4: We’ll email you to confirm your portal registration request and send a second email once it’s approved. Please allow 2–3 business days for processing.
Access Member Information
Everything you need to know about a member — right at your fingertips.
- Check claims status or view detailed claim lines by claim ID, date of service, member ID, or name
- Find member coverage details, including accumulators, cost share, and plan type
- Verify eligibility and coverage start date before providing services
- Review member benefit documents like the BCM, EOC, and SBC
- See a member’s primary care physician (PCP) and participating provider group (PPG)
Tools, Forms and Pharmacy Resources
Support your practice with easy access to key forms, updates, and clinical tools.
- Use quick links to the formulary and prescription drug prior authorization form
- Access provider resources like the Provider Manual, medical policies, and clinical practice guidelines
- Submit online prescription prior authorizations
- Download essential forms including the Member Grievance Form and Provider Forms
- Stay informed with regular provider updates
- Review member rights and responsibilities