Whether you’re starting a solo practice or partnering with fellow medical professionals to start a private medical practice, you’ll likely encounter the complexities of medical credentialing. As exciting as launching a healthcare practice may be, the administrative burden that comes with credentialing can be overwhelming. Delays in credentialing can prevent providers from seeing insured patients, lead to revenue losses, and even harm a practice’s reputation.
This is where professional medical credentialing companies come into play. By outsourcing the process to credentialing experts, providers can ensure faster enrollment with insurance payers, minimize paperwork, and avoid costly mistakes. Credentialing services streamline the entire process, starting from initial application to continuous follow-ups, so that healthcare providers can focus on delivering quality patient care.
There are a variety of credentialing Companies in the United States that makes choosing the right partner a challenging task. To help medical practitioners make an optimal choice, we’ve curated a list of best credentialing services based on their expertise and key features. So, if you’re a new provider starting your own practice or an established physician expanding your affiliations with insurance payers, give this guide a read.
Top Medical Credentialing Companies in the USA
According to the ResearchAndMarkets report, the healthcare credentialing market is expected to reach $1.42 billion by 2030, growing at a CAGR of 8.3% from 2024. These increasing stats underscore the growing need for reliable credentialing solutions.
Here’s a curated list of some of the best credentialing companies in the United States, based on their industry expertise, service features, and client satisfaction:
- Transcure
- Practolytics
- Verisys
- National Credentialing Solutions (nCred)
- CureMD
- Azulity
- Physician Practice Specialists
- Capline Healthcare Management
- Ace Med Assist
- Armored MBS
Let’s begin with the first company on the list.
1. Transcure
Transcure’s promise to build life-long partnerships with its clients has earned it the number-one spot among the best medical credentialing companies in the USA. Our dedicated team of credentialing experts helps enroll with the widest range of insurers, including Medicare, to attract more customers and increase revenue.
To minimize the paperwork hassle for healthcare providers, we handle the entire credentialing lifecycle from initial submissions to approvals and renewals. We will constantly coordinate with you from early submissions to follow-ups and final approvals. This helps you sign up with maximum insurance companies and increase your revenue significantly.
Moreover, we track your applications throughout to ensure faster approval and prevent delays. Also, our experts follow up to date healthcare laws and requirements to keep your practice fully compliant. With experience serving over 500 providers and an impressive 99% customer retention rate, we’ve built a reputation for reliability, accuracy, and results that speak for themselves.
Standout Features of Transcure for Medical Credentialing
- Offers complementary medical credentialing services to its clients who choose the complete suite of RCM services.
- Holds all the necessary certifications, including AICPA SOC 2, HIPAA COMPLIANT, and ISO 27100.
- Utilize billing services across 40 specialties to maximize practice revenues.
- Provides robust billing dashboards for real-time revenue tracking and performance analytics.
- Trained professionals in your EHR to make your practices well-organized.
2. Practolytics
Having perfected the revenue management cycle for healthcare practitioners, Practolytics is also making its mark on the list of top medical credentialing companies. The company specializes in 28 different healthcare niches and has 20+ years of experience in the healthcare IT industry, providing transformational solutions for its clients.
You can partner with Practolytics at any stage of your credentialing application. It can involve initiating your credentialing process, CAQH verifications, and re-credentialing with insurance programs. Practolytics also helps you with adding or removing a partner, Medicare re-validation and Medicaid re-enrollments, hospital privileges, and more.
Standout Features of Practolytics
- Tracks application progress and offers bi-monthly progress reports of your credentialing process.
- 98% success rate in first time application approvals.
- Supports Medicare, Medicaid, and various private insurance plans.
- Helps eliminate up to 45% of claim denials caused by credentialing issues.
- Offers medical billing services across 17 specialties.
3. Verisys
With 30+ years of experience in the healthcare industry, Versiys is one of the best medical credentialing companies in the United States. It verifies credentials such as professional licenses and other data sets from the primary bodies. The credentialing process is robotic and fully automated to ensure accuracy and save time.
Verisys partners with all 50 state medical boards to verify licensing and certification for healthcare providers and related businesses. Moreover, multiple credentialing standards have accredited them, including NCQA credentialing, Joint Commission credentialing, and URAC credentialing.
Standout Features of Verisys
- Offers a variety of credentialing solutions, for instance, in-house teams, outsourced credentialing facilities and hybrid options.
- Partnered with the CAQH and integrated it into its workflows, streamlining the application process.
- Automatically enroll verified licenses into monitoring and receive instant alerts on status changes, new actions, and renewal reminders.
- Validates NPI numbers with accuracy of 99.98%.
- Receive real-time alerts on exclusions, sanctions, and licensure changes to enable immediate compliance action.
4. National Credentialing Solutions (nCred)
nCred’s distinguishing feature among other medical credentialing companies is its exclusive proficiency in medical credentialing services. The company began operations in 2011 as a group of medical practice management professionals. Based on their past credentialing experience, they grew the organization and specialized in payer-provider enrollment for medical practitioners with varying specialties.
Additionally, it has achieved the remarkable feat of serving all states within the United States and accommodating the maximum number of health plans. This best credentialing service offers provider enrollment, CAQH, Medical license renewals, credential verification, and more.
Standout Features of nCred
- Create and maintain your CAQH profile with expert help.
- Impressive record of serving 5,200 providers and processing 61,000 applications.
- Notifies you about your expired licenses, certifications, and insurance policies via online platform.
- Facilitates workflow automation, making the whole medical credentialing process quick.
- Customize services to match your organization’s exact credentialing requirements.
5. CureMD
While CureMD is not a medical credentialing company in the traditional sense, its practice management ecosystem does help streamline the complex provider credentialing process. CureMD is a well-known organization that provides medical billing and credentialing services.
Based in New York, it has been in the health IT industry since 1997. It specializes in EHRs and advanced medical billing practices. Moreover, CureMD has won multiple accolades, including top EMR and customer success awards. Furthermore, they offer a comprehensive set of features beyond credentialing, thus facilitating your ideal healthcare practice.
Standout Features of CureMD
- Enroll quickly in government healthcare programs like Medicare and Medicaid.
- Complete essential registrations including NPI, CAQH, and PECOS.
- Manage licensing and certifications such as state licenses, DEA certificates, and CLIA compliance.
- Provides access to a cloud-based online portal 24/7 to monitor credentialing status in real-time.
- Stay active with payers through timely revalidation and re-credentialing.
6. Azulity
Healthcare providers can also trust Azulity, another respectable physician credentialing company based in the US. This organization is renowned for its deep understanding of healthcare operations and has expertise specific to healthcare data management, staffing, and credentialing.
Talking specifically about the credentialing services, Azulity helps you build or expand your medical staff services team with experienced credentialing professionals. They have access to a nationwide network of experienced experts, including consultants, contractors, coordinators, and specialists, who are well-trained on the medical credentialing process.
Standout Features of Azulity
- Offers remote, hybrid, or onsite staffing models.
- Train teams with up to date knowledge and tools to increase productivity.
- Use skilled SEMs to organize, analyze, and manage complex health care data.
- Centralize provider information using advanced provider MDM solutions.
- Trusted by seven top healthcare insurance companies like BlueCross BlueShield Association, MultiCare, and more.
7. Physician Practice Specialists
Ranked as the top rated credentialing company in the US, this company provides credentialing experts nationwide in all states. PPS handles the entire credentialing and enrollment process for solo practitioners, hospitals, FQHCs, and more. They manage payer applications, follow ups, and confirmations so providers can focus more on patient care rather than credentialing hassle.
This company also prevents provider termination from payer networks due to missed credentialing updates. Apart from that, healthcare providers can even use their advanced credentialing software for application completion, submission, and tracking.
Standout Features of Physician Practice Specialists
- Handle Medicare and Medicaid revalidations.
- Enroll new providers at a 20–50% discounted rate.
- Provides complimentary payer audits for practices with 5 or more providers.
- Offers RCM services for efficient revenue management.
- Delivers efficient EHR consulting services for medical practices.
8. Capline Healthcare Management
Capiline Healthcare Management is also among the best credentialing companies in the US. With years of expertise in the healthcare industry, this company simplifies the credentialing tasks for doctors, hospitals, and clinics. They specialize in handling the complex credentialing process from application to approval, including CAQH and PECOS registrations.
Moreover, Capline’s trained credentialing experts manage all documentation and form submissions to minimize the administrative workload on providers. And you know the best part? This company processes credentialing applications twice as fast as typical in-house teams.
Standout Features of Capline Healthcare Management
- Provides continuous visibility and updates on credentialing progress.
- Uses advanced tools to ensure compliance and accuracy through automated background checks and ongoing monitoring.
- Verifies credentials directly from official sources to maintain high accuracy and compliance.
- Tracks re-credentialing cycles and sends reminders.
- Offers timely enrollment in EFT programs with participating payers.
9. Ace Med Assist
Ace Med Assist provides top credentialing services across the United States that are tailored to meet the unique needs of medical practices of all sizes. They help providers enroll with insurance companies to expand patient access. Ace Med Assist also conducts thorough primary source verifications to ensure accurate validation of every provider’s education and certifications.
Apart from that, their professional team expertly handles credentialing application processing and submits error-free applications to prevent delays. They also manage payer enrollment and contracting, securing approvals from top insurance payers just within 90 days.
Standout Features of Ace Med Assist
- Utilizes cutting-edge technology to ensure speed and accuracy.
- Prioritizes open communication with clients to keep them updated throughout the process.
- Keep credentials updated with timely re-credentialing and ongoing maintenance.
- Maintain full HIPAA compliance across all credentialing processes.
- Provides expert help across 30 specialities and coverage for over 100 medical domains.
10. Armored MBS
Among the top rated credentialing companies in the US, Armored MBS delivers reliable credentialing solutions to healthcare providers. This company supports various providers, including physicians, labs, hospitals, and more. Moreover, Armored MBS provides end-to-end credentialing services, from new enrollments to credentialing and expiration management.
Additionally, they offer timely information regarding expiration dates and ongoing credentialing monitoring, which makes them an excellent partner. The best thing about this company is that it is affordable as the service package starts at $120.
Standout Features of Armored MBS
- Enroll with PPO, HMOs, and Medicare providers.
- Update provider demographics accurately and quickly.
- Setup and maintain CAQH profiles without any error.
- Handle re-credentialing processes before deadlines.
- Negotiate better fees with insurers to boost revenue.
Conclusion
Medical credentialing is a time consuming task, which is full of hassle for medical healthcare providers. To simplify the credentialing process and save time, providers turn to reliable credentialing services. This detailed guide presents the ten leading medical credentialing services in the U.S, each with unique strengths and specialties. Among all the companies, Transcure is highly recommended due to its efficiency, comprehensive support, and proven success in fast enrollments.
