Credentialing

Non-Contracted Providers

Non-Contracted Providers must apply for network participation and be approved in order for practitioners to complete the Credentialing Process. To complete the application process on the South Country Health Alliance (South Country) website, click on Providers > Forms > Non-Contracted Providers, and complete the Provider Contract Application > Web Form.

Credentialing Process

Please note that submitting a credentialing application is NOT a contract for provider participation. If you or your organization is not contracted with South Country, please see the Non-Contracted Providers section above for instructions to apply for a contract.

New Credentialing DHS Requirement for 2022
Effective 1/1/2022, Minnesota DHS is requiring MN Health Plans to complete practitioner Initial Credentialing Applications that are deemed to be “clean applications” within 45 days of receipt of the application. A “clean application” is an application that is complete in its entirety, includes all information required to process the application, and does not require evaluation of any identified potential quality or safety concerns.

Initial and Reappointment Application Submission Requirement for 2022
The South Country credentialing staff has determined that applications received through the Minnesota Credentialing Collaborative (MCC) system are more legible, completed in their entirety, reduces staff time requesting missing information, and allows for quicker processing turnaround time resulting in timely reimbursement payments to providers. In an effort to complete timely processing of credentialing applications and to meet the new Minnesota DHS requirement to approve clean credentialing applications within 45 days, South Country has made the determination to require all credentialing Initial and Reappointment Applications be submitted using the MCC system effective 1/1/2022.

To get started using MCC, visit their website and access user guides - Get Started (www.mncred.org)(external link).

For additional assistance using the MCC system or getting set up call 847-425-4616.

Additional Information regarding use of the MCC system:

  1. Streamlines the Initial Credentialing Application submission process for providers by allowing a provider to complete the credentialing application one time and submitting to multiple hospitals and health plans with just a click.
  2. Streamlines the Reappointment Credentialing Application submission process for providers by allowing a provider to simply review information submitted at the time of initial credentialing, update changed information and signatures, and submit.
  3. For $30 a year, your data stays with you. Updates are easy. Send data to hospital and health plans with just a click.
  4. The MCC system allows Clinic Administrators to manage multiple providers from one administrator account.
  5. When setting up your MCC profile to submit applications, please choose the option to receive email updates as South Country will communicate application processing and approval dates through the MCC system.

 Credentialing Forms

Credentialing Tips for More Efficient Application Processing

  • Credentialing applications should be submitted at least 90 days prior to the practitioner’s start date with the contracted organization. *South Country does not assign retroactive effective dates.
  • Complete credentialing applications in their entirety as incomplete applications delay the credentialing process.
  • Include an email address to receive important communications from South Country.
  • Include additional languages you fluently speak.
  • Completing Race/Ethnicity questions is highly encouraged to better serve South Country’s diverse population membership.
  • Include effective start dates, whether you’re accepting new patients, and if you’d like to be suppressed from South Country’s provider directories for each practice location.
  • State the specialty you currently provide to South Country members in the Primary Specialty field. If also providing a secondary/tertiary specialty, please state in the Subspecialty field.
  • All date fields must be in month, day and year format.
  • Explain employment gaps that exceed 3 months.
  • If no hospital admitting privileges, please describe coverage for continuity of care.
  • Professional references must have personal knowledge of your current (within past 12 months) clinical skills, abilities, judgment, professional performance, and clinical competence or have been responsible for professional observation or your work (limit to 1 current office associate). Do not include your residency or fellowship director, relatives or pending partners. At least 1 reference should be in your specialty/subspecialty.
  • Enter an affirmative response and detailed explanation to all applicable Disclosure Questions.
  • Updating the Attestation Update signature/date does not update the Authorization Release or Application Validation Statements. You must also update these application pages with your signature/date.
  • Include current copies of applicable professional state licensure, DEA registration and malpractice liability insurance certificate.

Rights and Notification

  • Practitioners shall have the right, upon written request, to review their credentialing file except for information that is privileged or protected from such disclosure and to submit corrective statements with respect to the initial application. South Country Health Alliance or its Third Party Administrator (TPA) will place the corrective statement in the practitioner's credentialing file, but this does not require South Country Health Alliance or its TPA to alter or delete any information contained in the file.
  • Practitioners shall be informed of any information discrepancies and shall have the opportunity to correct erroneous information gathered during the credentialing
    process, prior to review by the South Country Health Alliance Credentialing Committee.
  • Practitioners, upon request, shall be informed of the status of their credentialing or recredentialing application.

Credentialing Contacts

General Credentialing Email: credentialing@mnscha.org

Credentialing Supervisor: Jeanette Horn - jhorn@mnscha.org

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