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Provider Enrollment Contracting

Provider Enrollment Contracting

NEW INFORMATION FOR PROVIDERS:

As of June 17, 2022, providers should no longer submit credentialing applications directly to Sandhills Center. Sandhills Center will accept NC Tracks credentialing as documented in the NC Tracks Provider Enrollment File and/or the NC Tracks Operations Portal.

The North Carolina Department of Health and Human Services (NCDHHS), through NCTracks, will continue to collect information and verify credentials for all providers currently enrolled or seeking to enroll in North Carolina’s Medicaid and/or Health Choice programs or as a State-funded service provider. Sandhills Center will continue to verify that providers have been enrolled in NCTracks, ensuring required taxonomy, site, and service prior to executing a provider contract or enrolling an affiliated practitioner into Sandhills Center’s network.

This change was made in accordance with the North Carolina Department of Health and Human Services, Division of Health Benefits contract Amendment #23, regarding provider credentialing. If you have submitted an application prior to June 17, 2022, but have not yet received notification of approval, your enrollment will be finalized, and a contract will be issued without delay upon confirmation of enrollment in NCTracks and DHHS Centralized Credentialing approval.

IMPORTANT ANNOUNCEMENT FOR AGENCIES, FACILITIES, AND GROUPS REQUESTING TO AFFILIATE A LICENSED PRACTITIONER    

Please be advised that a Licensed Practitioner’s effective date with Sandhills Center is the date of approval by our Contracting Committee or Chief Medical Officer/Chief Clinical Officer and IS NOT TIED TO THE EFFECTIVE DATE IN NCTracks.  You will still need to notify Sandhills Center if you need to add LPs to your agency, and they will still need to go through our verification process.  Although we now utilize information The Department’s Centralized Credentialing Provider Enrollment File, we still must confirm licensure information from the Clinician’s board separately, as well as confirm they are not on the State Exclusion List or other regulatory body’s sanction list.  You will be notified if we are unable to add an LP found on an exclusion list, or if the LP requires additional consideration from our contracting committee. Clean LPs will be put on our Selection Grid and approved within five (5) business days of receipt of the Request to Affiliate form.  

Request to Affiliate Form

Please email the completed form to selectionretention@sandhillscenter.org


About the Sandhills Center Network

Sandhills Center is a North Carolina Medicaid 1915 (b/c) waiver site, which establishes our network as a single Prepaid Inpatient Health Plan (PIHP) through which mental health, substance abuse and intellectual/developmental disabilities services (I/DD) will be authorized and paid. Sandhills Center handles authorizations and payments to providers for all appropriately-delivered Medicaid services for Medicaid enrollees in Anson, Davidson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph, Richmond and Rockingham counties.

Provider Enrollment/Contracting Instructions

Sandhills Center is a closed network. Exceptions to join the network are considered on a case by case basis determined by current geographical and clinical area of needs. The following services are exceptions identified through our gaps analysis:

Interested providers are strongly advised to contact Network Operations at ProviderJoin@SandhillsCenter.org to determine Sandhills Center's current identified needs. If you feel your request meets exception criteria, please fill out the Request to Join Network form and submit to: ProviderJoin@SandhillsCenter.org. A "Request to Join Network Form" must be completed with all requests in order to be considered.  

Current Providers

If you are currently enrolled as a Licensed Practitioner under an agency or hospital in the Sandhills Center Network, and want to become a solo LIP, or if you are a solo LIP that wants to apply as an agency, please send a Change of Business Model request e-mail to ProviderJoin@SandhillsCenter.org. In order to determine if your request meets the criteria for an exception, please send a letter of justification which demonstrates the value that this change would bring to the Sandhills Center network. Requests should include a list of specialty areas of practice you are rostered and certified for, years of experience, and number of Sandhills Center Medicaid members you currently serve, or estimate you will serve, and current referral sources. Please include a copy of your resume (and in the case of an agency request, all resumes for providers who will practice with you). Please send justification, along with the Request to Join Network form, and submit to ProviderJoin@SandhillsCenter.org.

Confirmation of enrollment in NCTracks is reviewed per Sandhills Center policies/procedures regarding exception requests. If approved, then the next step would be the execution of a contract. 

Upon a decision of the reviewed request, a notification of the decision will be emailed. 

A "Request to Join Network Form" must be completed with all requests in order to be considered.

Questions? Submit Provider Enrollment Questions Here