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Facility Credentialing 2025

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The document outlines the application process for facility credentialing with Sanford Health Plan. It details the necessary steps, required documentation, and contact information for submitting applications. Key requirements include legible completion of the application, provision of specific licenses and insurance certifications, and adherence to deadlines to avoid processing delays. The document also includes sections for legal entity information, service location details, accreditation, and liability insurance coverage.

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Click ‘Get Form’ to open the Facility Credentialing application in the editor.
Begin by entering your contact information, including your name, email address, and phone number. Ensure all details are legible.
Fill in the Legal Entity Information section with the name on your income tax return and Tax ID Holder/Facility Name. Provide the Federal Tax ID Number and legal address.
Complete the Billing Information section if it differs from the Legal Entity. Include Pay To Name and Federal Tax ID Number.
For each service location, provide detailed information such as facility name, address, NPI numbers, and whether you are accepting new patients.
Attach required documents like State Facility License and Liability Insurance Certification using our platform’s upload feature.
Review all sections for completeness and accuracy before signing and dating the application. Remember that signatures must be within 60 days of submission.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (120 Votes)
2019	4.3 Satisfied (30 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What comes first, credentialing or privileging?

Credentialing is closely tied with privileging and is frequently a first step for physicians seeking hospital privileges.

What are the different types of credentialing?

Licenses and certifications are the two primary types of credentials. Credentials can also be earned via apprenticeships. Some state licensures may be earned by passing national exams.

What are the three types of credentialing?

Credentialing Specialists provide administrative support in healthcare settings. Their job is to verify that all medical staff members credentials and licenses are valid and up to date.

What are the four main types of credentials for a career in health care?

What are the Main Types of Medical Credentials? Academic Degrees. Academic degrees represent the foundational education that healthcare professionals receive. Licensure. Board Certification. Professional Designations and Certifications. International Medical Credentials.

What is the job description of a facility credentialing?

While provider credentialing services focus on verifying individual providers, facility credentialing services involve a broader scope, ensuring an entire organization meets payer, accreditation, and regulatory requirements.

What are three key pieces of information needed for credentialing?

Gathering provider information Credentialing begins with the collection of essential documents and data, including educational certificates, licenses, residency completion records, and work history.

Facility Credentialing 2025

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How to use or fill out Facility Credentialing with our platform

See more Facility Credentialing versions

Complete this form in 5 minutes or less

Got questions?

What comes first, credentialing or privileging?

What are the different types of credentialing?

What are the three types of credentialing?

What are the four main types of credentials for a career in health care?

What is the job description of a facility credentialing?

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What are three key pieces of information needed for credentialing?

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Facility Credentialing 2025

Here's how it works

How to use or fill out Facility Credentialing with our platform

See more Facility Credentialing versions

Complete this form in 5 minutes or less

Got questions?

What comes first, credentialing or privileging?

What are the different types of credentialing?

What are the three types of credentialing?

What are the four main types of credentials for a career in health care?

What is the job description of a facility credentialing?

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People also ask

What are three key pieces of information needed for credentialing?

Related links

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