Starting a solo practice or joining hands with fellow medical professionals to venture into private medical practice, you’re likely to encounter the complexities of medical credentialing. You must have asked around and heard about common hurdles you face while starting. Credentialing companies charging upfront fees, high revenue sharing percentages, and the difficulty of choosing the right platform with the rise of newer alternatives are a few of them. Therefore, the crucial first step is to understand the role of medical credentialing companies.
Medical credentialing is essential for healthcare practitioners in the US. At the same time, it is well known that the whole process is complex, multi-step, and time-consuming. If you’re a medical professional, you will prefer not to get into all the administrative work and look for reliable guidance.
This is where the role of medical credentialing companies comes in. Over the years, healthcare providers like yourself have come up with credentialing struggles. Your feedback has helped companies improve their services significantly and make the whole process carefree.
For this guide, the strengths and weaknesses of multiple medical credentialing services were researched and identified. The following list is the careful culmination of efforts to give valuable customers the best possible guidance.
Choose from the following five best medical credentialing companies and safeguard your revenue.
Before we start exploring the healthcare credentialing companies on the list, let’s understand the crucial factors you should consider before choosing a medical credentialing company.
How to Choose a Medical Credentialing Company?
Without proper guidance, choosing the right healthcare credentialing company can be frustrating and tiresome. By understanding the aspects illustrated below, you will be able to make the best choice.
1. Experience and Expertise
Consider both technical and non-technical factors to evaluate the experience and expertise of a medical credentialing company.
Non-technical aspects include their length of experience in the industry, specialization in your healthcare niche, and client reviews.
Technical aspects are essential. What type of software do they use? How much manual and automated work is involved in their credentialing process? Also, look into their process for safeguarding your data and the frequency of updates on the credentialing application status.
Requesting proposals, reading online testimonials, and scheduling consultation meetings with the companies is an easy way to assess all these aspects.
2. Services Offered
Assessing the company’s core credentialing services is also essential. Primary Source Verification (PSV) is the first step in credentialing. Ask if they verify the credentials, such as education, licensure, etc., directly with the issuer and their operating procedure.
The credentialing application process is long and arduous. Fundamentally, the company you choose should help you every step of the way. It includes gathering documents, filling out forms, and coordinating with the payers.
Equally paramount is to check whether the company you choose can enroll you with your specified insurance companies for timely reimbursement. This can significantly reduce your trouble and streamline your credentialing.
Lastly, you can ask if they offer re-credentialing and license monitoring services to relieve you of future hurdles, such as license expiration issues.
3. Technology and Security
Another critical point in selecting the right credentialing company is evaluating its technology and security apparatus.
You can ask the following questions for a comprehensive assessment:
- What are the key features or highlights of the credentialing software you use?
- How do you ensure data security? What data confidentiality protocols do you follow? And How do you respond to data breaches?
- Are you a HIPAA complaint? Can you provide the required documentation?
These important questions will give you an overview of the technology and security infrastructure of that particular company. More so, you will be able to narrow down your final option based on the information you get from these companies.
4. Pricing and Transparency
One major issue every healthcare professional encounters is doubtful pricing and a lack of transparency by medical billing and credentialing service providers.
There are frequent instances where you are billed with hidden charges, and the final cost exceeds the company’s quoted cost. Different medical credentialing companies may also overcharge you for a similar credentialing service.
You can eliminate this potential risk by consulting more companies and making pricing comparisons. Then, you can make a final choice by selecting the company that seems trustworthy.
Top Medical Credentialing Companies in the USA
The following list has been curated with utmost care and responsibility. This guide’s goal is to make your decision to choose the right medical credentialing services less exhaustive.
The companies were selected after considering all the aspects described above, including experience, expertise, service specialization, and pricing transparency. Furthermore, metrics like testimonials, success rates, and compliance certifications helped us curate our selection to your needs.
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. We believe that credentialing is only the first step in a healthcare professional’s revenue management cycle. Therefore, we guide our customers to focus on long-term benefits.
We work for healthcare practices of all types and sizes. Our more than 12 years of experience in the healthcare IT industry has helped us perfect our strategies and services. We are experts in 34+ medical specialties, which can be leveraged to maximize your practice revenue significantly. Our existing clients have been getting excellent results.
To quote a few numbers, after working with 500+ providers and maintaining a customer retention rate of 99%, we were able to secure 500 million dollars worth of claims, which is 2.7 million record claims processed, and the number keeps growing.
Standout Features of Transcure for Medical Credentialing:
Transcure offers complementary medical credentialing services to its clients who choose the complete suite of RCM services. The pricing options are reasonable and transparent. You are only charged a small percentage of your revenue.
Dedicated credentialing teams at Transcure assist you every step of the way. 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.
Furthermore, our firm commitment to complete revenue cycle management, starting with credentialing, has produced excellent results for our clientele. Making sure providers are credentialed with the right payers has helped us significantly drop claim denials and increase reimbursement rates. This, in turn, has produced millions in revenue and has driven extended customer success.
We hold all the necessary certifications, including AICPA SOC 2, HIPAA COMPLIANT, and IS0 27100. This helps streamline your credentialing application process without any hurdles.
As a technology-oriented company, Transcure has trained professionals who are well-versed in all popular electronic health records (EHRs). This technology improves the operational speed and cost of your medical practice.
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 has it all covered. Practolytics also helps you with
Practolytics can assist you with adding or removing a partner, Medicare re-validation and Medicaid re-enrollments, hospital privileges, and more.
Standout Features of Practolytics for Medical Credentialing:
Practolytics tracks application progress efficiently and offers bi-monthly progress reports of your credentialing process.
Another essential step is timely CAQH attestation. This minimizes delays and allows the application to move to the next step at the right time.
Practolytics has direct access to insurance representatives in most states. This helps in two ways: quickly understanding the process and getting a timely outcome.
Their credentialing process involves four steps. The first step is onboarding, during which you are assisted in selecting the insurance companies of your choice. Next, your application will be completed by obtaining the necessary details. The third and fourth steps involve following up on the application and insurance approvals, respectively.
The company has received excellent reviews from its customers, which shows its commitment to its promises and timely delivery.
3. Verisys
Verisys’ history dates back to 1992; Founders John O’Shaughnessy and Dick Kusserow established Government Management System (GMS) whereby a database called Fraud Abuse Control Information System (FACIS) was created. This intelligent system was capable of tracking suspected medical providers. Today, FACIS has collected 10 million records, making it the gold mine of healthcare professionals’ data. In 2007, GMS was named Verisys by John Benson, a short form for the verification system.
The organization claims higher credentialing success rates to back its bold claims. They monitor 8 million providers annually directly from 3500+ primary sources, which is a true testament to their years of expertise in the healthcare IT industry.
Multiple credentialing standards have accredited them, including NCQA credentialing, Joint Commission credentialing, and URAC credentialing. So, whatever standard you follow, they stay compliant with most of them.
Standout Features of Verisys for Medical Credentialing:
Healthcare organizations get end-to-end assistance for medical credentialing services in partnership with Verisys.
Some of them include access to a national database for detailed background checks, automation of license verification and monitoring, and alerts for expiring credentials.
The Verisys platform also offers personalized workflows that meet your organizational or personal demands. This feature ensures the efficiency and accuracy of the healthcare credentialing process.
Verisys offers a variety of credentialing solutions—for instance, in-house teams, outsourced credentialing facilities and hybrid options.
CAQH is a crucial step in the medical credentialing process. Verisys has partnered with the Council for Affordable Quality Healthcare and integrated it into its workflows, streamlining the application process.
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.
nCred has been included in the list of the foremost medical credentialing and billing companies for the year 2025, attributed to its impressive record of serving 5,200 providers and processing 61,000 applications. Additionally, it has achieved the remarkable feat of serving all states within the United States and accommodating the maximum number of health plans. nCred also offers provider enrollment, CAQH, Medical license renewals, credential verification, and more.
Standout Features of nCred for Medical Credentialing:
National Credentialing Solutions strongly believes in modern technology-based solutions for the healthcare industry. Their custom-built cloud-based software platform accurately depicts this vision.
Their online platform gives you direct access to your file and its status. You can also be notified of your expired licenses, certifications, and insurance policies with this platform.
Their software program facilitates workflow automation, making the whole medical credentialing process quick and efficient by reducing the hurdles of manual work.
You are assigned a dedicated team. Each person is responsible for a different task in the application, ensuring that the whole process runs smoothly.
With nCred, you don’t have to send emails or make calls to get updates on your application. You can log in to your online account and check the status of your credentialing requests.
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.
We have included CureMD in the list due to its years of experience serving 30,000 practices since its inception. Furthermore, they offer a comprehensive set of features beyond credentialing, thus facilitating your ideal healthcare practice.
Standout Features of CureMD for Medical Credentialing:
You get a dedicated system profile to store all your credentialing-related information.
It includes contact details, academic background, licenses, DEA information, work history, and insurance details. This feature has numerous benefits, such as reducing data collection time, eliminating scattered data, and minimizing the risk of information loss.
CureMD offers enrollment in government healthcare programs, including Medicare and Medicaid. With the company’s dedicated support, you can also enroll in Medicare DMEPOS.
Moreover, commercial insurance credentialing is also part of their services. Their dedicated credentialing experts also negotiate terms with particular payers to earn better reimbursement rates for you.
The CureMD also handles NPI registrations, CAQH profile maintenance, and PECOS management. More so, you are facilitated in licensing and certification compliance with the authorities.
Other than these technical details, you can benefit from their dedicated teams for each task, constant application status updates, and 24/7 application access via their cloud-based online portal.
Conclusion
Medical Credentialing can become overwhelming without the proper guidance. This detailed guide highlights the key factors to consider when choosing from medical credentialing companies and presents five leading options, each with unique strengths and specialties.
Now, it is up to you to carefully compare these options for the best medical credentialing services and choose the one that best serves your practice needs. The list includes companies with multiple years of experience in the healthcare IT industry and vibrant reputations, as well as companies with limited experience but exceptional results.
Start by connecting with these healthcare credentialing companies, communicating your requirements, and hearing how they can provide exceptional results for your healthcare practice.
