Sandhills Center
Member & Recipient Services:
1-800-256-2452
TTY:
1-866-518-6778
Behavioral Health Crisis Line:
1-833-600-2054
Nurse Line:
1-888-846-1058
Provider Pharmacy Line:
1-888-846-1062
Main Menu
Enrollment and Contracting

Enrollment and 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 - PDF

Please email the completed form to selectionretention@sandhillscenter.org


PROVIDER ENROLLMENT & CONTRACTING INSTRUCTIONS

The Sandhills Center Tailored Plan is a closed network. Exceptions to join are considered on a case-by-case basis, determined by current geographical and clinical areas of need. 

Sandhills Center maintains an open network for Medicaid providers of physical health and pharmacy services. All network contracting decisions for providers of physical health and pharmacy services are based solely upon the credentialing information provided by the North Carolina Department of Health and Human Services (NCDHHS).

The following services are exceptions identified through our gaps analysis:

Interested providers are advised to contact Network Operations to determine Sandhills Center's current identified needs. If you believe your request meets exception criteria and you are registered in NCTracks to provide the service you are requesting, please complete the Request to Join Network (PDF) form and submit it to: ProviderJoin@SandhillsCenter.org. A Request to Join Network form must be completed with all requests to be considered.  

CURRENT PROVIDERS

If you are currently contracted as a Licensed Independent Provider (LIP) under an agency or hospital in the Sandhills Center Tailored Plan 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. To determine if your request meets the criteria for an exception, please send a letter of justification that demonstrates the value that this change would bring to the Sandhills Center network.

Requests should include a list of specialty areas of practice for which you are rostered and certified, years of experience, and the 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).

Only sites and services you are registered to provide in NCTracks are eligible for consideration. 

Please send justification, along with the Request to Join Network form, and submit it to ProviderJoin@SandhillsCenter.org. Submitted documentation is reviewed per Sandhills Center policies/procedures regarding exception requests. All new providers/sites/services must be approved by the Sandhills Center Tailored Plan Board of Directors prior to the provision of any services.  The effective date of service will be included in any approval notices.

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

Have questions? Submit enrollment questions here.


feedback button