Medical Credentialing Services in USA
MGMA reports that approximately 54% of medical practices in the USA experience claim denials. Why? Just because of provider credentialing and enrollment errors, that cost practices an average of $122,144 over a 120-day credentialing delay. Do you also want to be a victim of avoidable revenue loss and delayed onboarding? No?
Get our medical credentialing services in the USA and eliminate costly delays, accelerate provider onboarding, and stay payer-compliant. With us, ensure 100% satisfaction while staying in-network with top insurers like Medicare, Medicaid, Aetna, and United Healthcare.
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We Overcome Provider Credentialing Challenges
Our US medical credentialing and enrollment services verify a provider’s qualifications, licenses, and professional history to meet strict standards set by insurers or hospitals. Providers face the following challenges without proper credentialing, which diminishes their worth when 75% of patients prioritize in-network providers.
Are delayed payer approvals and onboarding times holding back your revenue?
We fast-track enrollment by managing every step, from CAQH attestation to PECOS submissions, and reduce onboarding time by up to 40%.
Are incomplete or incorrect application details causing costly payer rejections?
Our physician credentialing audits every detail, maintains real-time provider data, and submits error-free applications to ensure fast-time approvals.
Tired of revenue loss from uncredentialed services?
Our expert insurance credentialing team offers a solution by aligning credentialing with your RCM processes to minimize AR days, prevent retroactive billing denials, and keep your revenue cycle intact.
Our End-to-End Medical Credentialing Services in USA
A large percentage of healthcare organizations’ claims denials are linked to credentialing and enrollment errors. So, making this process right is no longer optional. We deliver complete, compliant, enrollment and provider credentialing services. Here is a glimpse:
Healthcare & Insurance Credentialing
Our medical credentialing specialists manage provider credentialing with Medicare, Medicaid, and commercial payers like Aetna, BCBS, United Healthcare, Cigna, and Humana. From application prep to final approval, we ensure every detail meets payer requirements to prevent delays, denials, and revenue disruption.
Enrollment Services (Individual & Group)
Our outsourced insurance credentialing services in the USA are also available for solo practitioners, group practices, or facility administrators. We handle new enrollments, revalidations, and group affiliations and ensure all providers are properly listed with payers. This eliminates gaps in billing and network participation.
Hospital Privileging & Medical Staff Credentialing
Our physician credentialing experts facilitate providers to obtain and renew their hospital privileges with ongoing updates to keep their hospital credentials current. These are the rights and responsibilities granted by a hospital to a provider to practice within its facilities.
State Licensing, DEA & CLIA Support
We offer regulatory credentialing support from obtaining or renewing state medical licenses to handling DEA registration for controlled substance prescriptions and CLIA certification for labs. We manage your regulatory credentials end-to-end. We ensure full compliance with state and federal requirements.
CAQH Registration & Profile Maintenance
The Council for Affordable Quality Healthcare (CAQH) ProView is a centralized hub used by most private insurance payers for commercial insurance credentialing. We handle your CAQH registration, ensure profile accuracy, and manage ongoing attestations.
Medicare DMEPOS Enrollment
If you provide durable medical equipment, prosthetics, orthotics, or supplies (DMEPOS) and need government insurance credentialing, we manage your Medicare DMEPOS enrollment. Our US medical credentialing experts ensure full compliance with CMS regulations and help you avoid rejections.
Primary Source Verification (PSV) & Documentation
All payers, whether commercial or government, require Primary Source Verification of your credentials, like education, licenses, board certifications, etc. Our team ensures to meet PSV requirements quickly and accurately, supporting faster onboarding and preventing administrative delays in payer approvals.
Contract Negotiation & Reimbursement Optimization
Maximum HealthCare Partners also represents your interests during private payer contract negotiations, working to secure competitive reimbursement rates and favorable terms. This strategic service helps boost your practice’s revenue potential and maintain network compliance with top insurers.
Recredentialing, Monitoring & Compliance Management
Credentialing is not a one-time task, as it needs constant monitoring. Our provider enrollment services include tracking credential expirations, managing re-credentialing timelines for Medicare, Medicaid, and private payers. We ensure your credentials are always active.
Our End-to-End Medical Credentialing Services in USA
A large percentage of healthcare organizations’ claims denials are linked to credentialing and enrollment errors. So, making this process right is no longer optional. We deliver complete, compliant, enrollment and provider credentialing services. Here is a glimpse:
Healthcare & Insurance Credentialing
Our medical credentialing specialists manage provider credentialing with Medicare, Medicaid, and commercial payers like Aetna, BCBS, United Healthcare, Cigna, and Humana. From application prep to final approval, we ensure every detail meets payer requirements to prevent delays, denials, and revenue disruption.
Enrollment Services (Individual & Group)
Our outsourced insurance credentialing services in the USA are also available for solo practitioners, group practices, or facility administrators. We handle new enrollments, revalidations, and group affiliations and ensure all providers are properly listed with payers. This eliminates gaps in billing and network participation.
Hospital Privileging & Medical Staff Credentialing
Our physician credentialing experts facilitate providers to obtain and renew their hospital privileges with ongoing updates to keep their hospital credentials current. These are the rights and responsibilities granted by a hospital to a provider to practice within its facilities.
State Licensing, DEA & CLIA Support
We offer regulatory credentialing support from obtaining or renewing state medical licenses to handling DEA registration for controlled substance prescriptions and CLIA certification for labs. We manage your regulatory credentials end-to-end. We ensure full compliance with state and federal requirements.
CAQH Registration & Profile Maintenance
The Council for Affordable Quality Healthcare (CAQH) ProView is a centralized hub used by most private insurance payers for commercial insurance credentialing. We handle your CAQH registration, ensure profile accuracy, and manage ongoing attestations.
Medicare DMEPOS Enrollment
If you provide durable medical equipment, prosthetics, orthotics, or supplies (DMEPOS) and need government insurance credentialing, we manage your Medicare DMEPOS enrollment. Our US medical credentialing experts ensure full compliance with CMS regulations and help you avoid rejections.
Primary Source Verification (PSV) & Documentation
All payers, whether commercial or government, require Primary Source Verification of your credentials, like education, licenses, board certifications, etc. Our team ensures to meet PSV requirements quickly and accurately, supporting faster onboarding and preventing administrative delays in payer approvals.
Contract Negotiation & Reimbursement Optimization
Maximum HealthCare Partners also represents your interests during private payer contract negotiations, working to secure competitive reimbursement rates and favorable terms. This strategic service helps boost your practice’s revenue potential and maintain network compliance with top insurers.
Recredentialing, Monitoring & Compliance Management
Credentialing is not a one-time task, as it needs constant monitoring. Our provider enrollment services include tracking credential expirations, managing re-credentialing timelines for Medicare, Medicaid, and private payers. We ensure your credentials are always active.
Offering Credentialing Services For Providers All Across the USA
You can outsource physician credentialing services to Maximum HealthCare Partners because we proudly cater to the needs of all healthcare organizations. With us, ensure fast approvals, regulatory compliance, and smooth payer integration.
- Hospitals & Healthcare Systems
- Physicians and Specialists
- Nurse Practitioners and Physician Assistants
- Behavioral Health Providers
- Physical Therapists and Occupational Therapists
- Durable Medical Equipment (DME) Suppliers
- Telehealth Providers
- Multi-Specialty Clinics and Group Practices
- Laboratories & Diagnostic Imaging Centers
- Federally Qualified Health Centers (FQHCs), etc.
USA #1 Medical Credentialing Performance Metrics
| Metric | Industry Average | With Maximum HealthCare Partners |
|---|---|---|
|
Credentialing Turnaround Time Clean Claims Rate AR Days Denial Rate Due to Credentialing Errors |
90-120 days 85% 50+ days 10% |
30-60 days 98% 30 days Near-zero denials |
Outsource Insurance Credentialing & Enrollment Services Now!
Why struggle with delays, denials, and administrative overload when you can partner with US credentialing experts? Here are the benefits of outsourcing medical credentialing to Maximum HealthCare Partners :
Credentialing Isn’t Admin Work
Think credentialing is just form-filling? No! Every payer has different timelines, formats, portals, and documentation rules. Missing one step can delay reimbursements. So, hire us and get access to the US#1 provider credentialing experts.
Insurance Payers Change Rules
Payer protocols, CMS rules, and commercial network requirements shift constantly. Internal teams fall behind fast. We monitor payer updates in real time and ensure your applications are always aligned to prevent denials before they happen.
Full Compliance & Regulatory Assurance
By outsourcing physician credentialing services to us, you can avoid compliance risks and penalties. The team follows Medicare, Medicaid, CAQH, and commercial insurance payer regulations and keeps your practice audit-ready.
Receive More Revenue
Our contract negotiation strategies secure the best possible reimbursement rates for providers. It means we help you earn more for your services by assisting you in in-network enrollment, securing payer contracts, and incentive-based programs.
Outsource Insurance Credentialing & Enrollment Services Now!
Why struggle with delays, denials, and administrative overload when you can partner with US credentialing experts? Here are the benefits of outsourcing medical credentialing to Maximum HealthCare Partners :
Credentialing Isn’t Admin Work
Think credentialing is just form-filling? No! Every payer has different timelines, formats, portals, and documentation rules. Missing one step can delay reimbursements. So, hire us and get access to the US#1 provider credentialing experts.
Insurance Payers Change Rules
Payer protocols, CMS rules, and commercial network requirements shift constantly. Internal teams fall behind fast. We monitor payer updates in real time and ensure your applications are always aligned to prevent denials before they happen.
Full Compliance & Regulatory Assurance
By outsourcing physician credentialing services to us, you can avoid compliance risks and penalties. The team follows Medicare, Medicaid, CAQH, and commercial insurance payer regulations and keeps your practice audit-ready.
Receive More Revenue
Our contract negotiation strategies secure the best possible reimbursement rates for providers. It means we help you earn more for your services by assisting you in in-network enrollment, securing payer contracts, and incentive-based programs.
Serving All Medical Disciplines in the USA
You can outsource physician credentialing services to Maximum HealthCare Partners because we proudly cater to the needs of all healthcare organizations. With us, ensure fast approvals, regulatory compliance, and smooth payer integration.
Ophthalmology
Oncology
Dermatology
Neurology
Radiology
Psychotherapy
Ambulatory Surgery
Paediatrics
Gastroenterology
OB/GYN, etc.
Measurable Success by Maximum HealthCare Partners
Choose us for credentialing in medical billing, as we define success in numbers :
- 98% First-Pass approval rate on credentialing applications across commercial and government payers.
- 30% faster enrollment turnaround compared to industry averages, minimizing onboarding delays. $12 M+ in revenue secured annually through optimized credentialing and payer contract management.
- 80% fewer credentialing-related claim denials for our partnered practices.
- 100% compliance track record with CMS, CAQH, and major insurer requirements.
Our 4-Step Medical Credentialing Process
We follow simple steps to take the complexity out of the provider credentialing with a results-driven, compliance-focused approach.
1
Strategic Credentialing Assessment
When you hire us, our credentialing specialist analyzes your practice type, specialty, licensure status, and geographic scope. Then we assess your eligibility and strategically map the best-fit government and commercial insurance networks.
2
Documentation Collection & Verification
We gather all required documentation, including NPI, DEA, state licenses, board certifications, malpractice insurance, and training history. Our team verifies every credential with primary sources and sets your CAQH ProView profile.
3
Application Preparation & Submit it
Our enrollment credentialing expert completes and submits applications to specific payers. We also avoid credentialing bottlenecks by ensuring timely approvals, tracking the progress, taking follow-ups, and resolving issues.
4
Enrollment Confirmation & Monitoring
The team confirms approval and then helps providers with payer contract negotiations and reimbursement optimization. Our process includes real-time credentialing monitoring, automated re-credentialing alerts, and full compliance reporting.
Frequently Asked Questions
Credentialing companies handle the entire provider enrollment and insurance credentialing process from collecting and verifying documents to submitting applications to payers. Maximum HealthCare Partners manages CAQH profiles, ensures compliance, and secures timely approvals.
Credentialing is about verifying qualifications and licenses, but enrollment means applying and being accepted into insurance networks. Both are essential, and we handle them simultaneously to ensure your fast reimbursement.
The required documents include your state license, board certifications, malpractice insurance, educational background, work history, and specialty-specific certifications or credentials.
Credentialing timelines differ according to payer and region, but on average, approval takes 90–120 days. However, with our proactive follow-up and process tracking, we often accelerate this timeline by 30% or more.
