Credentialing application submission

Related app:  Credentialing application status

Review the section below for the documents needed to upload with your submission.

Practitioners will receive written notification once their initial application has been approved.

Please mail credentialing fee(s) as noted on the application invoice.

Initial Credentialing

To begin credentialing with HealthPartners or adding privileges at a new hospital/entity:

  • Fully completed MN Uniform Credentialing Application OR Update Application
  • Copy of Malpractice Face sheet
  • Health History form and documentation
  • Hospital Attestation, Secondary Interests Disclosure form and Designated Physician Coverage form, as applicable.
  • Delineation of Privileges form
  • Hospital specific staff category form(s)
  • Background forms (MN/WI specific)

Reappointment

  • Reappointment Worksheet, including Disclosure questions, explanation for any affirmative answers, Authorization and Release, Peer Reference Page.
  • Copy of Malpractice Face sheet
  • Hospital Attestation and Secondary Interests Disclosure form
  • Delineation of Privileges form
To request a Hospital credentialing packet please email HospitalCredentialing@HealthPartners.com .

You can check the status of your application by any of the following:

Initial Credentialing

Before credentialing can begin, you must be a contracted provider or have been offered a contract.

Reappointment

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