Summit Pointe strives to ensure a comprehensive Provider Network is available for our customers when choosing resources for service provisions identified within their individualized plan of service. These resources must meet the qualifications and service standards outlined in the Medicaid Manual under Behavioral Health and Intellectual Disability Supports and Services. External providers will be required to maintain compliance with Medicaid, DHHS, and Summit Pointe standards and guidelines for all service provisions under the contract, including provider qualifications.
New Providers interested in joining the Summit Pointe Provider Network can contact either the Strategic Alliance Director or Administrative Coordinator.
Summit Pointe engages in a credentialing process for all providers within its Provider Network. Summit Pointe utilizes the Southwest Michigan Behavioral Health Credentialing Applications for Independent Practitioners, Licensed Organizations, and Unlicensed Organizations to obtain information regarding the provider’s service provision in order to initiate this process; along with the Summit Pointe Code of Ethics, SWMBH Federally Funded Health Care Disclosure form, and W9.
Providers are required to include evidence of licensure, certifications and liability insurance/worker’s compensation when submitting the credentialing packets.
The credentialing process involves conducting background and quality assurance verification via multiple resources such as the System for Award Management, Office for Inspector General, LARA, and the National Practitioner Data Bank. Re-credentialing includes these components as well as compiling site review materials, substantiated Recipient Rights complaints, and Grievances and Appeals.
Summit Pointe utilizes a Credentialing Committee whose role is to review and make final recommendations and approval regarding credentialing and re-credentialing decisions for inclusion of providers within the Summit Pointe Provider Network.
Providers are able to obtain information on the status of their credentialing request via the Summit Pointe Administrative Coordinator. Recommendations of the Credentialing Committee are communicated to providers in writing within ten (10) days of making a decision.
In the event of an adverse determination, notification will be in writing and will specify the reasons for the adverse credentialing decision and the provider will be notified of their right to appeal and/or dispute the decision, and the process for such appeal and/or dispute.
Additional information on Summit Pointe Credentialing/Re-credentialing standards guidelines are contained within the policies and procedures available on this website for your reference.
For providers interested in becoming part of the Summit Pointe Provider Network, please complete the appropriate credentialing packet and submit all required documentation to the Administrative Coordinator at email@example.com or fax 269-966-2844
- SWMBH Licensed Organization Credentialing Application
- SWMBH Unlicensed Organization Credentialing Application
- SWMBH Independent Practitioner Credentialing Application
- Summit Pointe Clinical Code of Ethics
- SWMBH Federally Funded Health Care Disclosure Form