• Care Coordination
• Clinical Integration
• SFHCP Contracting
• SFHCP Contract Listing
• Credentialing
• Education
• Fee Schedule Look-Up
• Medical Director Oversight
• Quality Improvement
• NCQA Programs
• Patient Satisfaction
• Provider Relations
• Research

Credentialing

Credentialing at Saint Francis HealthCare Partners (SFHCP) means less paperwork for physicians and their office staff and one point of contact for SFHCP payors. SFHCP has been awarded delegation of credentialing by multiple insurance payors, many of which are NCQA Accredited.

SFHCP staff responds to all requests from SFHCP payors for credentialing and recredentialing information. That means physicians may receive one request every three years for updated credentialing information rather than individual requests from each payor. In 2009, SFHCP began utilizing the Council for Affordable Quality Healthcare (CAQH) online database to obtain the majority of provider information necessary to complete recredentialing; thus further eliminating requests for additional paperwork from our physicians.

SFHCP credentialing and recredentialing follows the standards of the National Committee for Quality Assurance (NCQA). SFHCP has been approved by many of the payors to perform this function on their behalf.

Additionally, SFHCP and Saint Francis Hospital and Medical Center (SFH&MC) Medical Staff Office share a common physician application.  Active or associate privileges at SFH&MC are a requirement for SFHCP membership.  

Physicians interested in joining SFHCP begin the credentialing process by contacting the Medical Staff Office at 860.714.4088 to request an application for hospital privileges.  

Completed physician applications are returned to the Medical Staff Office, which in turn submits application copies to SFHCP for credentialing. 

Physicians must also contact SFHCP directly for a SFHCP credentialing packet, which includes the documents necessary for the insurance credentialing with SFHCP's contracted payors.

SFHCP provides credentialing for physicians with the following designations: MD, DO, DDS, DMD and DPMs. Credentialing of mid-level practitioners is done by the practitioner office directly with the individual health plan.  

Contact Amy Mattex, Credentialing & Physician Practice Solutions Consultant at 860.714.5755 for more information.