Sanford Health Plan has updated the provider enrollment and credentialing process for individual practitioners and facilities. Once a Provider Contract has been executed with Sanford Health Plan, we will begin our provider enrollment and credentialing process following NCQA standard guidelines.
A Provider Contracts Specialist will contact you when the New Provider Contract Request Form has been submitted and reviewed. A participation agreement and provider payment methodology will be sent to the contact person listed on the form. Existing Sanford Health Plan Providers with contracts go to Step 3.
For any additional questions on the New Provider Contract, please contact Provider Contracting at:
Toll-free: (855) 263-3544
The provider enrollment form must be completed for any newly contracted providers.
This form will begin the process for the credentialing application process. After submitting, a Sanford Health Plan representative will reach out to utilize the Sanford Provider Hub for the next steps of the process.
Sanford Provider Hub offers a secure solution for all credentialing activities through Sanford Health Plan with a user-friendly interface and automation to streamline the credentialing process and significantly reduce paperwork.
Fill out the Provider section of this form if you have a provider update. Examples include: adding/removing a provider, demographic changes
Fill out the facility section if you have a facility update. Example include: Facility name changes, tax id changes, phone number or address updates.
We request a 60-day notice to be able to communicate these changes to our members.
The facility credentialing application must be completed for any newly contracted facility or when adding a facility to your current contract. Once completed, email to firstname.lastname@example.org for processing. An on-site survey may be deemed necessary to approve an application.
Sanford Health Plan maintains policies for our credentialing and recredentialing process. For access to our policies, simply click on the appropriate link below.