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FAQs about provider contracting

I am leaving a clinic that is contracted with Moda Health and starting my own practice. What do I do to continue participating?

Your participation does not extend to a new clinic if you leave a participating practice. You are not guaranteed a contract at a new location or private practice through any previous affiliation with a participating group. Please submit the new provider Contracting Request form for your new practice location if the panel for your specialty is open in your geographic service area. Once your request has been reviewed, we will contact you at the email address included in your inquiry itself within 60 days.

I am credentialed. Does this mean I am participating/in-network?

No, credentialing and contracting are separate processes. Credentialing approval does not mean you are a participating provider with Moda Health. To be participating, you or your clinic must have a fully executed contract with an effective date.

I have a new provider joining my clinic, and our clinic is already in-network with Moda Health. What do I need to do?

Your new provider will need to be credentialed before they can be added under your clinic roster. Please email our credentialing team at to verify credentialing status, and submit the new provider's credentialing application. Once credentialing has been approved, the new provider will be added under your clinic's existing contract.

Why is the panel closed to new provider participation for my specialty?

We review our provider panels annually to determine areas of need. If the panel for your specialty is closed, we are above capacity for that provider type in your geographical service area. Please check back for changes to panel availability.

I already have a contract with Moda Health and want to add a new location. What do I need to do?

If the new location will be using the same Tax ID as your existing participating clinic, all you will need to do is email our provider updates at and provider relations at to notify them of the new clinic location. If the Tax ID will be different, please submit a new provider network participation request form.

I am already contracted with Moda Health and am trying to join a network that I am not participating with. What do I do?

Contact our provider relations team at to discuss the possibility of being added to that network. Then, we will contact you.

The panel for my specialty is not open to new participation, but I want to appeal to participate with Moda Health. What do I do?

Please email , and a contracting representative will review your case.

How long does it take to get contracted?

The average turnaround time for a response to a new contracting request is 30 business days from date of submission. Average time to full execution from the date the contracting request is submitted is 90 – 120 days. This time period will be extended if providers require credentialing, as credentialing must be completed before a contract offer is sent. Once the offered contract has been signed and returned to Moda Health, it can take an additional 30 days to set up the contract in our system before it goes into effect.

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