We continually seek to expand our network of providers to serve the needs of our growing membership. We are setting the standard for progressive community care: holistic, altruistic, and most importantly, personal.
We invite you to learn about the benefits of being a part of the Samaritan Health Plans network. Thank you for your interest in becoming a participating provider.
Begin the process to be considered for participation in our networks.
Be sure to keep your practice information current to ensure timely payment and accurate listing in our provider directory. You can add or remove a provider from your group and update panel availability and provider information.
Holistic & Alternative Services Providers
We utilize CHP Group for our alternative and holistic services for Samaritan Employer Group Plans members. Please contact the Provider Recruiting Department with CHP Group at 800-449-9479.
All interested health care professionals and facilities are required to be credentialed to be part of the Samaritan Health Plans network. Submitting all required documentation with your application can help ensure your credentialing is not delayed. Credentialing can take up to 90 days from receipt of a complete credentialing file.
What Is Credentialing?The credentialing process includes verification of education, experience, competence and licensure of health care providers.Which Providers Need to Be Credentialed?Most licensed providers will need to complete the Oregon Practitioner Credentialing Application (OPCA).Which Providers Need to Be Validated?The validation form is intended for unlicensed behavioral health providers and traditional health workers. If you are unsure which form to use, contact the Provider Relations team at email@example.com. Are There Any Providers Who Do Not Need to Be Credentialed or Validated?Yes. Most practitioners who practice exclusively within the hospital or inpatient setting are not required to be credentialed by Samaritan Health Plans. How Long Does Credentialing & Validation Take?Credentialing and verifications can take up to 90 days from the date SHP receives a completed application.What Does a Complete Credentialing Application Consist Of?When completing the credentialing application, the following elements are required:
I Submitted My Credentialing Application. What Happens Next?The credentialing staff will begin processing your application and will contact you if there are any questions or if additional documentation is needed. Make sure your contact information is current to avoid unnecessary delays.
How Do I Know When My Credentialing Is Complete?You will be notified by the credentialing staff confirming the credentialing process is complete.Where Can I Find the Credentialing or Validation Application? Credentialing and validation forms can be found on the Samaritan Health Plans’ Provider website under the Join Our Network section.Is There Anything I Can Do To Speed up the Credentialing Process?Unnecessary delays can be avoided by completing the credentialing application accurately and including all required documents. Your application will not be processed until all required information is submitted. Review your application in detail before submitting it. Common issues are missing signatures or initials, not completing a section or missing documents.How Often Do I Need to Be Credentialed?Once you are credentialed, you will need to be re-credentialed every two to three years. Staff from the SHP Credentialing Department will contact you when it’s time to submit your application.Where Do I Submit My Credentialing Application?Completed applications and attachments can be emailed to: firstname.lastname@example.org.Do You Have Any Tips for Making the Credentialing Process Smoother in the Future?The credentialing process can be time-consuming but following these tips will assist with the organization of your application and documents.
Review and complete the following credentialing forms:
The Oregon Practitioner Credentialing Application
The Oregon Practitioner Recredentialing Application
Organizational Provider Credentialing Application
Medical Provider Validation Application
For more information, please visit the OHA State Application page.
Contracting is contingent on credentialing approval. Samaritan Health Plans follows CMS and NCQA requirement for credentialing providers. The following is a listing of information that Samaritan Health Plans needs in order to credential practitioners and other health care professionals:
Note: Your Credentialing Application will not be processed until all required documents are received, and your application is considered complete.
Exceptions: Providers who practice exclusively in an inpatient setting and who provide care to Samaritan Health Plan members’ as a result of the member being directed to the hospital or other inpatient setting are not required to be credentialed by Samaritan Health Plans.
For more information, contact Samaritan Health Plans’ Provider Services at 888-435-2396 or 541-768-5207, Monday through Friday from 8:30 a.m. to 5 p.m. PT.
The following is a listing of information Samaritan Health Plans needs in order to credential facilities:
For more information, contact Samaritan Health Plans’ Provider Services at 888-435-2396 or 541-768-5207Monday through Friday from 8:30 a.m. to 5 p.m. PT.
Effective Jan. 1, 2023, Samaritan Health Plans/InterCommunity Health Network Coordinated Care Organization pays for covered services provided to our members during the credentialing period at the in-network benefit and under the terms of the contract. For this to apply, the credentialing application must be approved by the carrier. Please do not bill for these services until AFTER your credentialing is approved. Claims submitted without approved credentialing will be denied and require resubmission after approval in order to receive payment.
Reimbursement would start on the date the completed credentialing application is received by the Credentialing Department or the effective date of the contract between the provider and SHP/IHN-CCO; whichever is later.
If the credentialing application is denied or there isn’t a contract in effect between the provider and SHP/IHN-CCO on the date of service, the services will be considered out-of-network and processed according to that benefit.
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