The contracting and credentialing department of St. Luke’s Health Partners (SLHP) is comprehensive to ensure that its providers and facilities meet the standards of professional licensure and certification. This process enables SLHP to recruit and retain a quality network of providers and ensure ongoing access to care. And, it assesses and evaluates a provider’s or facility’s ability to deliver quality care between credentialing and recredentialing cycles. The credentialing program enables SLHP to ensure that all providers and facilities are continuously in compliance with network policies and procedures, and any other applicable regulatory and accreditation requirements.
The credentialing program includes providers who have an unrestricted, current and valid license and a National Provider Identification (NPI) Number. The process follows standards outlined by NCQA and complies with state and federal statutes.
In partnership with St. Luke’s Centralized Verification Office, SLHP accesses information from various resources including national certifying boards, appropriate state licensing boards, the Office of the Inspector General Exclusions list, the National Provider Data Bank and other sources as required. Providers are not considered participating in the network until after the credentialing and contracting processes are complete.