Best Health Care Credentialing Software

Health care credentialing software automates and simplifies the process of vendor, facility, and insurance provider credentialing. To stay compliant with health care facility policies and requirements, credentialing software takes over the manual process of verifying, screening, and generating contracts, applications, and other forms. The software optimizes front and back health care office operations and workflows. Additionally, health care credentialing software can prepare health care organizations for audits, securely store reliable and/or up-to-date provider information, and ensure that all documents and accreditations are easy to find and remain secure.

To qualify for inclusion in the Health Care Credentialing category, a product must:

  • Maintain or provide access to updated and accurate provider information
  • Automate time-consuming processes such as primary source verification and committee review
  • Centralize and privilege patient data
  • Adhere to industry and/or facility-specific requirements
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Health Care Credentialing reviews by real, verified users. Find unbiased ratings on user satisfaction, features, and price based on the most reviews available anywhere.

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    Direct Care Innovations (DCI) is a healthcare technology company that creates business management platforms for providers and government agencies.

    Cortex EDI is a leading clearinghouse and practice management software vendor for electronic medical transactions. Cortex EDI assists providers in every step of the revenue cycle from verifying patient eligibility to sending claims and tracking receivables.

    MedicsPremier is a practice management solution that has clearinghouse claims, auto-eligibility checking and auto-modifiers, patient/provider credentialing, copayment displays, and more.

    The Cactus Provider Management Platform is a web-based provider management solution that provides an easy and effective way to manage your provider information, from initial application, to provider credentialing & privileging, to provider enrollment, to peer review, practice benchmarking, analytics & incident reporting, all the way to recredentialing.

    MSOW solutions allow customers to take advantage of privileging solutions that help analyze criteria across departments.

    CE and CME to help clinicians stay current, meet licensing requirements and refine skills to improve performance.

    SkillSurvey Credential OnDemand® enhances the onboarding experience for everyone by easing and speeding the credentialing process.

    TriZetto offers consulting, IT, and business process solutions to streamline the deployment and adoption of technologies and improve operations for payers and providers in the health care industry. TriZetto solutions are designed to improve efficiency, accuracy, compliance, and results throughout the health care system.

    CredentialMyDoc is designed for all medical organizations with licensed providers who need to enroll with payers for reimbursement, as well apply and maintain privileges with healthcare facilities.

    Cerner Corporation's HealtheRegistries solution allows EPs/ECs to attest to MU and ACI programs Clinical Data Registry option of the Public Health Objective. HealtheRegistries provides the technology to track and manage quality measures to improve population health outcomes. To meet the Public Health Objective, EPs/ECs are eligible to electronically submit data from a Certified Electronic Health Record Technology (CEHRT) to HealtheRegistries via HealtheIntent.

    Intake.io is a real-time insurance eligibility & coverage verification software.

    MD-Staff is a modular web-based credentialing system with drag-and-drop privileging capability for healthcare industry.

    Watsi is a solution that directly fund life-changing health care for people around the world by meeting a patient, donating to to fun their care, and receive updates.

    ABN Assistant is the triage medical necessity for Medicare and private payers prior to service delivery.It verifies medical necessity pre-service and generates ABN or private payer notices as necessary and provides full reporting, chargemaster, coding, and administration tools.

    Patient registration and quality assurance solutions for providers who want to improve data accuracy and optimize patient flow.

    AlphaMCS tracks member demographics, provider performance, applications and contracts, service referrals and provision along with provider monitoring all in one end-to-end solution.

    Practice Management solution lets you manage patient records, insurance eligibility, documents, and billing in one place to maximize staff efficiency.

    Availity solves the communication challenges between healthcare stakeholders, creating a more transparent exchange of information between health plans, providers, and technology partners.

    Better Doctor is an healthcare marketplace that provides accurate doctor data, health plan directories, consumer review and APIs.

    CheckMedic is an online credentialing and management tool. It uses trusted data to help protect patients, sustain your reputation, ensure compliance, and speed onboarding. The MedPass is created from the CheckMedic process and is an all-inclusive, portable profile.

    The PayoIQ's payor change information provides immediate and substantial revenue management benefits to your practices as you seek to improve patient outcomes.

    The Converge Platform is a comprehensive, enterprise software solution that integrates silo'd departments, facilities and systems with a secure digital workspace and workflow for high risk/high-liability data, providing the insights necessary to proactively manage governance, risk and compliance.

    Offers a provider centric approach to credentialing with a focus on Profitability, Accountability & Accessibility

    CredSimple transforms provider credentialing into a fast, compliant and cost-effective process for healthcare organizations who are dissatisfied with inefficiencies that lead to burned out employees, dissatisfied providers and missed business opportunities.

    CubHub is a platform built specifically for pediatrics, rather than a Medicare-centered program with pediatric "work arounds." CubHub's outcomes-based data will enable you to partner more closely with private insurance companies, MCOs, referral sources, and key physicians—providing data to help you negotiate better contracts, get more referrals.

    Helps you meet pressures with a full range of BPO and turnkey healthcare administration solutions, including advanced technologies and strategic consulting services designed to help you optimize member outcomes, focus on revenues, and manage risk to remain compliant

    Easy Coder is a web-based coding tool designed to allow administrative and clinical staff to look up codes and perform edits all in one easy-to-use program.

    Echo Credentialing allows customer to take advantage of additional modules that will further optimize your platform and processes.

    eClaimStatus is a Health insurance eligibility verification software that is easy to Use, comes with zero setup or maintenance hassles ,assures real-time , eligibility verification from 700+ payers, fetches benefits data for 1 or 1000 patients in seconds , HIPAA compliant.

    edgeMED provides expert revenue cycle management and intelligent technology to increase physicians' revenue and improve their operational efficiency - enabling them to stress less, make more and live more. Our Essential medical billing and collection service tracks, measures and collects more of the money you’re owed in less time than you thought possible, so you can see more patients and less paper work. Our expert U.S.-based team, located in Boca Raton, Los Angeles and New York, will not only handle your back-office workload, but we’ll help optimize your entire revenue cycle to ensure your organization is running at maximum efficiency and profitability – all without any management headaches all too commonly associated with medical billing. Plus, with our cloud-based practice management/electronic health records and telemedicine applications you can provide better patient care, while unlocking obstacles to higher reimbursement.

    Breakdown operational barriers to scale and drive strategic growth while securing revenue streams.

    Enterprise Master Provider Index helps to consolidate disparate provider data into a single source to streamline processes in credentialing, scheduling, and revenue cycle management across the enterprise.

    Futura Practice Management is a Web-based practice management solution for small and midsized health care practices. The software features schedule management, which allows physicians to manage patient appointments.

    EMR that is fully integrated with practice management functionality, and free to offices with one to two providers.

    For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education and reporting into one easy-to-use, web-based solution. Designed by auditors, for auditors, Audit Manager allows you to audit on your terms through immediate reporting, template customization, and total oversight of your entire audit program. With Audit Manager, you will improve your auditing efficiency by up to 40%, minimize denials and identify up to 10% in missed revenue.

    HealthiPASS helps medical providers promote price transparency, build trust, and increase their operating income by simplifying the check-in process and streamlining both time-of-service and residual balance payments through a desktop iPAD kiosk interface.

    The HIPS system is a comprehensive and integrated solution that covers every aspect of health insurance administration. From credentialing providers through claims reimbursement and electronic payment, HIPS is designed to maximize scalability and minimize administrative costs by working in a completely user friendly web-based environment.

    For many Hospitals and Practices, Provider onboarding is often a long and drawn out process. Even Re-credentialing can feel like the process is starting from scratch.

    Web based solution for EHR with features such as lab integration, e-prescribing, and patient health records.

    IntelliCred simplifies the complex task of managing data in an efficient manner. Gather, store, and access the critical data you need to maintain accreditation and achieve the highest reimbursement possible for provider services.

    IntelliCVO can assist your organization with other important tasks like ongoing credentialing, privileging, and specialty projects

    This product is ideal for organizations that want to outsource all, or a portion of, the credentialing and/or provider enrollment process while still maintaining autonomy of their database through the software.

    Ready Doc™ completely redefines the healthcare credentialing process by creating a Hashgraph-based solution that will instantly verify a provider’s medical credentials—cutting months’ worth of processing time to a matter of seconds.

    KeyChart is designed exclusively for ophthalmologists. Prescriptions, referral letters creation, color drawing, equipment interfaces.

    Keys is the first credential app built for clinicians to securely store and continuously track your licensure, certifications and other credentials, automating the process so you can focus on your patients.

    Kyruus delivers provider search and scheduling solutions that help hospitals and health systems match patients with the providers best suited to care for them. The ProviderMatch suite of cloud-based applications--for access centers, consumers, & referral networks--enables a consistent patient experience across multiple points of patient access, while helping health systems align network capacity with patient demand. Kyruus’ provider data management platform, KyruusOne, forms the foundation of its solutions, powering them with accurate data. Our products include: * ProviderMatch for Access Centers - helps access center agents efficiently and effectively match and schedule patients with the right providers for their needs. * ProviderMatch for Consumers - enables consumers to search for providers, review comprehensive provider profiles, and book appointments on a health system’s website. * ProviderMatch for Network Referrals - allows providers to search for the right provides to refer to across their network and submit referrals to them efficiently online. * KyruusOne (provider data management) - automatically integrates data from multiple sources on an ongoing basis and provides user-friendly applications for effective provider profile configuration and maintenance.

    Provider Data Validation is a web-based, real-time provider information search service that leverages the most current, comprehensive and accurate provider data.

    LexisNexis ProviderPoint is a proven, powerful hosted solution that gives payers and other health care stakeholders a systematic way to keep provider information accurate and up-to-date, while significantly reducing operating costs. It delivers unrivaled depth, breadth and quality of information in a way that's easy to integrate and use.

    Simplify the financial experience for both patients and the people of your organization.

    Automate your release of information process with digital fulfillment. Turn your required services into a revenue generator through automation and high quality digital release of medical records and diagnostic imaging