Home » What We Do » Credentialing/Enrollment
Credentialing at SoNE HEALTH means less paperwork for practitioners and their office staff and one point of contact for SoNE HEALTH payors. SoNE HEALTH credentialing and recredentialing follow the standards of the National Committee for Quality Assurance (NCQA). SoNE HEALTH has been approved by the majority of the payors to perform this function on their behalf through delegation agreements which speed up the overall enrollment process.
The recredentialing process is done at least triennially and this information is communicated regularly to the delegated managed care plans. SoNE HEALTH utilizes the Council for Affordable Quality Healthcare (CAQH) online database to obtain the majority of provider information necessary to complete recredentialing; this further eliminating requests for additional paperwork from the majority of our practitioners.
Physicians must obtain and maintain Active or Courtesy membership, whether with or without clinical privileges at a Trinity Health Of New England facility. This is a SoNE HEALTH membership requirement.
Allied Health Practitioners must obtain privileges through the Medical Staff Office at a Trinity Health Of New England facility if they render patient care within the hospital setting.
Practitioners interested in joining SoNE HEALTH begin the credentialing process by contacting the Saint Francis Hospital and Medical Center Medical Staff Office at 860.714.4088 to request an application for hospital membership/privileges.
Johnson Memorial Hospital: 860.684.3682
Saint Mary’s Hospital: 203.709.3682
Mercy Medical Center: 413.748.9057
Another requirement for SoNE HEALTH physician membership is Board Certification. Physicians must obtain board certification in their practicing specialty within seven years of their last education and training or as determined by the specific board. Once obtained, board certification must be maintained to continue participation with SoNE HEALTH.
Allied Health Practitioners must also be certified upon credentialing and must maintain their certification to continue participation with SoNE HEALTH.
Physicians must also contact SoNE HEALTH directly by Email for a SoNE HEALTH credentialing/enrollment packet. The packet included the documents necessary for the insurance credentialing with SoNE HEALTH’s contracted payors.
SoNE HEALTH also monitors and manages all aspects of practitioner enrollment to its delegated payors including changes and terminations.
Please send any changes or terminations in writing by Email.