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Potential Provider Application

Thank you for your interest in participating with SilverSummit Healthplan. We are excited that you selected our provider network as your network of choice. We would like to build the best network to meet member needs.

  • To Join our network fill out a the following application. Please note that submission of a Letter of Intent is not a guarantee that you will receive a contract.
  • If selected, the Contracting Team will contact you and request information to complete your application.
  • Your application and documents will be reviewed in by the Contracting Committee.
  • Upon committee approval, the Contracting Team will contact you and request documents to complete your application. The timeline will be highly dependent on submission of documents
  • If approved, a Contract Negotiator will contact you to proceed with the contract
    • If not approved, you will receive an email and/or letter in the mail.

Contract FAQs

How will I know if I am approved or not approved?

If approved, you will be contacted by the Contracting team reviewing your application. If you are not contacted within 30 days, you have not been selected to join the network.

What happens after I am approved?

You will receive a request for documentation from the Contracting team. Upon receipt of all required documentation, you will receive a contract or outreach within 14 days regarding next steps in the process.  

If approved, what type of documentation will I need?

A Contracting team member will work with you to obtain all necessary documentation for credentialing and other contract load functions i.e., physician roster, DOO, etc.. The timeline for contracting process is highly dependent on the amount of time it takes to complete this step in addition to the accuracy of the documentation you provide. 

If approved, what is the expectation around effective date?

The effective date will be documented on the contract. Our company policy is that effective dates of the contract will be at least 60 days from the day both parties sign the agreement. This is to allow appropriate time to load the contract and perform necessary quality auditing to facilitate accurate claims payment. 

 

Choose Provider Request
Which product line(s) are you interested in?*

Contracting Representative

Provider Information

Provider Identification Numbers

Specialty & Services Provided

Populations Served

Additional Information

Attestation*