SOHO HEALTH performs the essential function of credentialing on behalf of its members. SOHO HEALTH provides credentialing for physicians and Allied Health Practitioners.
Credentialing at SOHO HEALTH means less paperwork for practitioners and their office staff and one point of contact for SOHO HEALTH payors. SOHO HEALTH credentialing and recredentialing follows the standards of the National Committee for Quality Assurance (NCQA ). SOHO HEALTH has been approved by the majority of the payors to perform this function on their behalf through delegation agreements which speeds up the overall enrollment process
The recredentialing process is done at least triennially and this information is communicated regularly to the managed care plans. SOHO HEALTH utilizes the Council for Affordable Quality Healthcare (CAQH) online database to obtain the majority of provider information necessary to complete recredentialing; thus further eliminating requests for additional paperwork from the majority of our practitioners.
Active or Courtesy membership, whether with or without clinical privileges at Trinity Health Of New England (THOfNE) facility are required for SOHO HEALTH membership.
Allied Health Practitioners must obtain privileges through the Medical Staff Office at THOfNE facility if they will be render any patient care within the hospital setting.
Practitioners interested in joining SOHO HEALTH begin the credentialing process by contacting the Medical Staff Office at 860.714.4088 to request an application for hospital membership/privileges.
Another requirement for SOHO 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 the SOHO HEALTH.
Allied Health Practitioners must also be certified upon credentialing and must maintain their certification in order to continue participation with SOHO HEALTH.
Physicians must also contact SOHO HEALTH directly at Amy.Mattex@sfhcp.org for a SOHO HEALTH credentialing/enrollment packet. The packet includes the documents necessary for the insurance credentialing with SOHO HEALTH’s contracted payors.
SOHO HEALTH also monitors and manages all aspects of practitioner enrollment to its payors including changes and terminations.