Contract Initiation
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 send an email inquiry to ProviderNetwork@summitpointe.org.
Credentialing
Summit Pointe engages in a credentialing process for all providers within its Provider Network. Summit Pointe utilizes the Southwest Michigan Behavioral Health Credentialing Applications to obtain information regarding the provider’s service provision in order to initiate this process.
Summit Pointe has 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.
To become a part of Summit Pointe’s Provider Network, the following items need to be submitted to the Credentialing Committee for review:
- SWMBH Credentialing Application
- SWMBH Federally Funded Health Care Disclosure Form
- Summit Pointe Clinical Code of Ethics
- W9
- Liability Insurance
- Worker’s Compensation Insurance (If applicable)
- Copy of Licensure (if applicable)
- Accreditation Certificate (if applicable)
- HCBS Provisional Approval Survey
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.
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.
Providers are able to obtain information on the status of their credentialing request via the Summit Pointe Provider Network Specialist. Recommendations of the Credentialing Committee are communicated to providers in writing within ten (10) days of making a decision.
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 Provider Network Specialist at ProviderNetwork@summitpointe.org or fax 269-966-2844.
Additional information on Summit Pointe Credentialing/Re-credentialing standards guidelines are contained within the policies and procedures available on this website for your reference.