Credentialing and enrollment

HealthPartners credentialing program supports the selection and retention of highly qualified and competent professional staff to meet our member's health care needs.

Credentialing is the process of assessing and validating the qualifications of a licensed independent practitioner to provide patient care. Individuals are credentialed when they apply for participation in a HealthPartners network and every three years thereafter.

To begin the credentialing process, you must be a HealthPartners contracted provider or work for a HealthPartners contracted provider.

If you are not already a contracted provider or working for a contracted provider, please submit a provider application prior to beginning the credentialing process.

Interested in contracting with HealthPartners?


How do I get credentialed with HealthPartners?

When a practitioner type that HealthPartners credentials joins a HealthPartners contracted clinic, the practitioner or clinic must complete a credentialing application.

ApplySmartTM system
HealthPartners uses the ApplySmartTM system, which is now owned by Aperture Credentialing. All MN-based medical clinics are required to use ApplySmartTM for submission of initial credentialing applications.

Practitioners or clinics can register for an account and use this web-based credentialing application for submission of the credentialing application to HealthPartners. Join Now at http://Mncred.org.

If you or your clinic has an ApplySmartTM account, log into ApplySmartTM to submit your credentialing application to HealthPartners.

Clinics in other states may use ApplySmartTM or continue to submit paper applications by fax or email. Medical and behavioral health practitioners or clinics complete the Minnesota Uniform Credentialing Application and fax at to 952-853-8702 or send by secure email to Credentialing@HealthPartners.com.

Dental providers or clinics complete the Initial Dental Credentialing Application and fax it to 952-883-5160 or email it to Dental Contracting.

Medication Therapy Management Pharmacists complete the Initial MTM Credentialing Application and fax it to 952-853-8702 or email it to Credentialing@HealthPartners.com.

Practitioners may not see HealthPartners members and will not appear in directories or in any Member Service resources until the credentialing process is completed and the application is approved.

 

How long does the credentialing process take?

The process can vary depending on completeness of the application, whether additional information needs to be obtained from the practitioner, and whether the practitioner meets all HealthPartners credentialing criteria. It is recommended that an application be submitted at least 90 days prior to employment date.

Practitioners will receive written notification once their application has been approved. Practitioners or clinics may also contact the HealthPartners Credentialing Service Bureau at 952-883-5755 to check the status of an application.

Practitioners may not see HealthPartners members and will not appear in directories or in any Member Service resources until the credentialing process is completed and the application is approved.

What to do if I am currently credentialed with HealthPartners and am joining a new clinic?
A practitioner who is currently credentialed with HealthPartners and is just changing to another HealthPartners contracted clinic site needs to notify HealthPartners.
How do I know if I am currently credentialed with HealthPartners?

Please contact HealthPartners Credentialing Service Bureau at credentialing@healthpartners.com or call (952) 883-5755.

What paperwork should be completed for non-credentialed practitioner types?

When a non-credentialed practitioner type joins a HealthPartners contracted clinic or is already enrolled in the HealthPartners provider network or just changes clinic sites, notify HealthPartners using the Minnesota Uniform Practitioner Change Form (with the Site Location Addendum if applicable) and fax or email to Provider Data Support.

Newly enrolled practitioners (except Interpreters) must submit a NPI to be enrolled with HealthPartners.


 

How can I review information about practitioners working in my clinic?

Contracted providers can manage clinic and practitioner information on-line using the Provider Data Profiles application available on the HealthPartners Provider Portal. This application offers practitioner information related to specialties, clinics, and personal profiles. To gain access to this time-saving tool contact your site administrator or contact web support.


 

Behavioral Health Practitioners

HealthPartners requests all behavioral health practitioners to identify age populations or services or verifiable expertise they provide. This information will help us better serve you and our members. Omission of this data will result in an inability to recommend you as provider for members requesting or needing specific behavioral health services.
To gain access to this convenient on-line tool, contact your site administrator or use the Contact Us link for assistance.

Do I need to inform HealthPartners if I leave my clinic?

It is very important that HealthPartners be notified when a practitioner leaves a contracted clinic.

It is recommended to use secured, encrypted email service to send private and protected information via email.

Submission Information
  • Medical, Behavioral Health and MTM Practitioners Credentialed by HealthPartners
    Fax: (952) 853-8702. Email for credentialing applications Credentialing@HealthPartners.com. Email for recredentialing applications Recreds@HealthPartners.com.

    HealthPartners Credentialing Service Bureau 21107Q
    P.O. Box 1309
    Minneapolis, MN 55440-1309
    Phone (952) 883-5755
     
  • Non-Credentialed Practitioners
    Fax: 952-853-8703 or e-mail: ProviderData@HealthPartners.com
     
  • Dental Practitioners
    Fax: 952-883-5160 or email: DentalContracting@HealthPartners.com
    HealthPartners Dental Credentialing
    Mailstop 21113A
    PO Box 1309
    Minneapolis, MN 55440-1309

Practitioner Types Credentialed by HealthPartners

Practitioner Type/Title Practitioner Type/Title Explanation
ADT Advanced Dental Therapist
APRN Advanced Practice Registered Nurse
(all Nurse Practitioner types except CRNA)
BCBA Board Certified Behavioral Analyst (WI Only)
CCDC II Certified Chemical Dependency Counselor II (SD only)
CCDC III Certified Chemical Dependency Counselor III (SD only)
CICSW Certified Independent Clinical Social Worker (WI only)
CMFT Certified Marriage and Family Therapist (Nebraska Only)
CNM Certified Nurse Midwife
CNP Certified Nurse Practitioner
CNS Clinical Nurse Specialist
CPC Certified Professional Counselor (ND/SD/WI only)
CSAC Clinical Substance Abuse Counselor (Must also be IndCS or INTCS)
CSW-PIP Clinical Social Worker in Private Independent Practice (SD only)
DC Doctor of Chiropractic
DDS Dentist
DMD Dentist
DO Doctor of Osteopathy
DPM Doctor of Podiatric Medicine
IntCS, CSAC Intermediate Clinical Supervisor,
Clinical Substance Abuse Counselor (WI only)
IndCS, CSAC Independent Clinical Supervisor,
Clinical Substance Abuse Counselor (WI only)
LAC Licensed Addiction Counselor (ND & SD only)
LADC Licensed Alcohol and Drug Counselor
LCPC Licensed Clinical Professional Counselor (IL only)
LCSW Licensed Clinical Social Worker (WI only)
LICSW Licensed Independent Clinical Social Worker
LISW Licensed Independent Social Worker (IA only)
LMFT Licensed Marriage and Family Therapist
LMHC Licensed Mental Health Counselor
LP Licensed Psychologist
LPC Licensed Professional Counselor (Must be able to practice independently)
LPC-MH Licensed Professional Counselor Mental Health (SD only)
LPCC Licensed Professional Clinical Counselor (ND and MN only)
LTM Licensed Traditional Midwife (MN only)
MBBCH Bachelor of Medicine and Bachelor of Surgery
MBBS Bachelor of Medicine and Bachelor of Surgery
MTM (PharmD, RPH) Medication Therapy Management Pharmacist
MD Physician
NP Nurse Practitioner
OD Doctor of Optometry
PA-C Physician Assistant Certified

Note: This list is subject to change

Non-Credentialed Practitioners

HealthPartners does not credential the following practitioner types, but they may need to be enrolled. See the "About Credentialing" Tab for further information.

  • Acupuncturists
  • Anesthesiologists (unless practicing pain management in a clinic setting)
  • Audiologist
  • Certified Genetic Counselors
  • Certified Registered Nurse Anesthetists
  • Certified Registered Nurse First Assistants
  • Critical Care Medicine
  • Critical Care Surgery
  • Dental Therapists
  • Pediatric Critical Care
  • ER Practitioners (unless also practicing in a clinic setting)
  • Interpreters
  • Neonatologists (unless also practicing in a clinic setting)
  • Neonatal Nurse Practitioners
  • Nutritionists
  • Occupational Therapists
  • Hospital-based OB/Gyn (contracted only to cover L&D call schedule)
  • Pathologists
  • Physical Therapists
  • Radiologists (except Radiation Oncologists)
  • Registered Dieticians
  • Registered Nurse
  • Speech Pathologists

Note: This list is subject to change

The HealthPartners Credentialing Plan describes the HealthPartners Credentialing Program. The purpose of the Credentialing Program is to support the systematic approach to credentialing within HealthPartners. Specific objectives of the Plan include:

  • Setting forth the criteria to be used in assessing the qualifications of applicants seeking initial or on-going association with HealthPartners.
  • Establishing the processes for verification and evaluation of a practitioner's credentials.
  • Establishing the processes for action if a practitioner's credentials do not meet the established minimum criteria.

Practitioner's Rights

Under HealthPartners Credentialing Plan, practitioners applying for initial participation or on-going participation have the following rights:

  1. The right to review the information submitted in support of their credentialing applications. Practitioners may call the HealthPartners Credentialing Service Bureau at (952) 883-5755 to arrange for a time to review their credentialing file. Practitioners are not allowed to review references or recommendations or other information that is peer review protected or otherwise protected by state or federal law.
  2. The right to correct erroneous information submitted by other sources.
    During the review process, credentialing staff will make note of any substantial discrepancies between the information reported by the practitioner and information obtained through the credentialing process. If a substantial discrepancy is identified, the practitioner is notified in writing of the discrepancy. The practitioner is given the opportunity to submit in writing, within 10 days, any corrections of erroneous information obtained from other sources or explanations for such discrepancies.
  3. The right to be informed, upon request, of the status of their credentialing or recredentialing application. Practitioners may call the HealthPartners Credentialing Service Bureau at (952) 883-5755 and ask for the status of their credentialing application.