Provider Enrollment & Credentialing

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.

STEP 1: Request a New Provider Contract

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 2.

For any additional questions on the Provider Enrollment Form, please contact Provider Relations at:

Toll-free: (855) 263-3544
Email: sanfordhealthplanprovidercontracting@sanfordhealth.org

Step 2: Provider Enrollment and Credentialing

Part A: Provider Enrollment Application

The provider enrollment form must be completed for any newly contracted providers or when adding a practitioner or facility to your current contract.

For any additional questions on the Provider Enrollment Form, please contact Provider Relations at:
Phone: (800) 601-5068
Email: providerrelations@sanfordhealth.org

Part B: Initial Credentialing Application Request form

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 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.

Sanford Provider Hub FAQ

For any additional questions on the Initial Credentialing Application Request Form, please contact us at:
Phone: (605) 312-7600
Email: VerificationServices@Sanfordhealth.org

Recredentialing

  • All Sanford Health Plan participating practitioners and facilities must be recredentialed at least every 36 months
  • At the time of your recredentialing, Verification Services will send an email providing you the next steps for use of the Provider Hub, add VerificationServices@SanfordHealth.org to your safe sender list to ensure you receive this email

Facility Credentialing Application

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 sanfordhealthplanprovidercontracting@sanfordhealth.org for processing. An on-site survey may be deemed necessary to approve an application.

Credentialing Policies

Sanford Health Plan maintains policies for our credentialing and recredentialing process. For access to our policies, simply click on the appropriate link below.