Partners is required to credential and re-credential all providers who participate in our Provider Network including, but not limited to Licensed Practitioners, Licensed Independent Practitioners, agencies (including group practices and licensed facilities such as Psychiatric Residential Treatment Facilities.) For specific information about credentialing, please review the Provider Operations Manual.
All credentialing requests should be initiated by submitting the appropriate form as indicated below. Instructions for submission are included on each of the forms.
All credentialing notices are sent to the primary credentialing contact identified by the applicant. If this or any other information is incorrect, your application could be delayed or denied. In addition, clinicians need to keep their CAQH applications up-to-date with accurate information. Partners relies on this information to be used to contact clinicians as needed for updates to credentialing status.
Provider agencies, clinicians, and licensed independent practitioners can keep track of credentialing expiration dates via the reports below:
- Licensed Independent Practitioner Credentialing Roster (updated March 2019)
- Provider Agency Credentialing Roster (updated March 2019)
- Clinician Credentialing Roster (updated March 2019)
Network providers bear the responsibility for keeping track of their credentialing expiration date(s). Agencies and Licensed Independent Practitioners (LIPs) and associated clinicians must maintain credentials to participate in Partners’ Provider Network. Therefore, providers who do not submit a complete Re-Credentialing Application before their credentialing expiration date must stop billing for both IPRS and Medicaid-reimbursable services. Continuing to bill for services after the credentialing expiration date may result in loss of revenue, recoupment, and/or contract suspension. In order to track the credentialing expiration dates of associated clinicians, Partners recommends that Network Providers use an internal auditing process.
Notice to Clinicians/Practitioners Who Bill Services:
The approval of credentials is only one requirement for network membership. A credentialed clinician/practitioner must have an executed independent contract OR be employed by a Network Provider to be a member of Partners Provider Network AND be eligible to bill for services.
For questions please contact Partners’ Credentialing Team at firstname.lastname@example.org or call 704-842-6483.
|I am a:||I want to:||I should:|
|Out of Network Provider Agency or
Independent Practitioner not employed by an In-Network Agency
|Join the Partners Network||Frequently check the Request for Services page and the Continuously Recruited Services page for network expansion opportunities.
Submit the Request for Nomination Form
|Licensed Practitioner employed by an In-Network Agency||Request initial credentialing with Partners||Submit the:
|In-Network Provider Agency||Request a new site or service||Complete the Partners’ Provider Change Form|
|Request updates or changes, including adding or removing a licensed practitioner currently credentialed with Partners
Release only required for changes of ownership/management.
|Complete the Provider Change Form
and when applicable, the Release and Consent for Background Form.
|In-Network Licensed Independent Practitioner||Request a new site or service; update or changes||Complete the Partners’ Provider Change Form|
|Out of Network Hospital||Contact Partners for a full contract at email@example.com||Submit the Hospital Data Form
|In-Network Hospital||Register additional licensed practitioners with Partners||Submit the Hospital Based Licensed Registration Worksheet|