Best Medical Credentialing Companies in Washington

Credentialing is how clinics get paid, providers join insurance networks, and patients use their benefits. In Washington State, from Seattle to Spokane, and from community clinics to telehealth programs, credentialing can keep revenue flowing or cause costly delays. This guide explains why credentialing matters and lists 15 companies that serve Washington providers. 

Why Credentialing Matters in Washington 

Credentialing is the system of verification and enrollment that confirms that your clinicians are licensed, trained, and qualified to bill insurers. Credentialing in Washington intersects with two major areas: 

State regulation and licensing 

The Washington Medical Commission (WMC) issues and regulates physician and PA licenses and publishes application procedures, forms, and state-specific rules. Without a current Washington license, payer enrollment and hospital privileges halt. 

Federal enrollment and Medicare 

PECOS (CMS’s online enrollment system) is used to enroll and maintain Medicare billing records. Many vendors complete PECOS and Medicare enrollment on behalf of clients. 

Top Medical Credentialing Companies Serving Washington 

1. Credex Healthcare  

Credex Healthcare specializes in provider credentialing; CAQH setup; PECOS/Medicare enrollment; payer-contracting follow-up; recredentialing management; dedicated account managers; transparent timelines; support for behavioral health, home health, private practices, and multi-specialty groups 

Best for:  Follow up with local payers, state licensing support, and regular recredentialing reminders to keep provider data current. 

Suitable for:  Small practices and telehealth teams that need fast payer access. 

How Credex Healthcare helps Washington providers 

Full CAQH setup and maintenance; PECOS/Medicare enrollment and revalidations; payer enrollment and appeals; primary-source verification and document assembly; recredentialing and ongoing monitoring; dedicated account manager 

2. VerityStream / HealthStream CredentialStream 

VerityStream is a credentialing company that is now part of the HealthStream ecosystem as CredentialStream.  

Highlights:  Enterprise credentialing with integrated primary-source verification, privileging workflows, and CVO services. 

Best for: health systems or large clinics that need automation and CVO-backed verification.  

3. symplr (including symplr CVO / IntelliCVO) 

Symplr provides enterprise credentialing software plus outsourced CVO services. 

• Enterprise credentialing software plus  

• Outsourced Credentials Verification Organization services. 

• Integrate software automation with verification teams 

Highlights

• Primary-source checks 

• Sanctions monitoring 

• Payer enrollment tracking 

A suitable choice for hospitals, health systems, and clinics that want one vendor that can both run the software and perform verification.  

4. Modio Health 

Modio Health is not just a simple credentialing company but a career management platform. 

Strong points

• Cloud-based credentialing 

• User-friendly interface for provider profiles  

• Primary-source verification workflows  

• CAQH integration  

• Good balance of automation 

• Cost control 

Best for: smaller groups and private practices that want a modern SaaS solution. 

5. Cactus Software 

Cactus is a credentialing software widely used by medical staff offices and hospitals.  

Highlights: Their platform supports packet creation, privilege tracking, and compliance reporting.  

Suitable for: medical staff offices requiring privilege packets and audit trails.  

6. Medversant 

Medversant is a credentialing firm that works as a Credentials Verification Organization and is used by integrated health networks. 

Highlights: 

• Provider data management 

• Reduces administrative burden 

• Speeds primary-source verification, and supports virtual review committees. 

 Best for: medium-to-large practices and health plans in Washington. 

7. Verisys

 

Verisys provides credentialing data services for state and federal programs 

Highlights: Mainly focuses on 

• Automated provider data  

• Compliance checks 

• Sanction monitoring  

• Identity verification 

Best for: organizations with significant regulatory requirements and public-sector contracts.  

8. MD-Staff 

MD-Staff is a credentialing software used by hospitals, long-term care networks, and clinics.  

Highlights: 

• Long-standing credentialing software platform 

• Workflow automation 

• Sanction monitoring  

• Primary-source verification modules 

Best for: credentialing teams that require a tried-and-tested system, continuous updates, and reporting capabilities 

9. IntelliSoft Group / IntelliCVO 

IntelliSoft Group provides services to many credentialing teams 

Highlights:  

• An integrated CVO stack 

• Credentialing automation tools  

• Powers service-oriented credentialing 

Best for: Credentialing automation across the U.S. 

10. CureMD 

CureMD, primarily known for its EHR and RCM and also offers payer-enrollment and credentialing services 

Suitable for: Outpatient clinics and specialty practices in Washington  

11. MediBillMD / MediBill RCM 

MediBillMD, a credentialing company that mainly focuses on credentialing and billing for small practices.  

Highlights

• Low-friction onboarding path to payer networks. 

• Packages credentialing with RCM.  

Best for

• Small behavioral-health groups,  

• New solo practitioners  

12. Billing Advantage 

Billing Advantage, a medical billing firm that also offers credentialing support. 

Highlights

• Keeps provider data consistent. 

• Payer enrollment 

 Best for: practices that avoid switching vendors while credentialing. 

13. PayrHealth 

PayrHealth is a credentialing firm that provides services from CMS forms to state Medicaid processes. 

Highlights: mainly focuses on  

• Payer-side paperwork 

• Follow-up 

• Medicare  

• Medicaid  

• Enrollment assistance 

Suitable for: complex Medicare or Washington Medicaid enrollments. 

14. Parallon (HCA/Parallon Credentialing Services) 

Parallon is the administrative arm of HCA Healthcare that runs credentialing and provider-onboarding programs for large hospital systems.  

Highlights: 

• Enterprise-level credentialing workflows 

Suitable for: practices affiliated with HCA facilities and multi-site organizations using Parallon’s platforms. 

Benefits of outsourcing credentialing services 

Cost-efficiency and predictable staffing 

• Predictable vendor fees; specialized knowledge and payer relationships. 

Time savings and faster in-network access 

• Avoidance of common application errors and timely responses. 

Fewer denials and cleaner claims 

• Accurate provider data across CAQH, PECOS, and payer portals reduces claim rejections. 

Audit readiness and compliance 

• Vendors with CVO experience  

• URAC or NCQA familiarity  

• documentation and audit trails 

Washington-specific credentialing checklist  

If you credential provider in Washington, use this checklist: 

Check state license and Washington Medical Commission (WMC) records

• Access license status and application forms, and instructions using obtaining a HELMS account if required for your profession.  

Develop or revise CAQH ProView

• The majority of commercial payers use a completed CAQH profile.  

• Maintain the CAQH ID and current attestations. 

Get or confirm NPIs in NPPES

Ensure NPPES records match tax and legal entity names. 

Medicare CMS enrollment through PECOS

• Use CMS’s PECOS for Medicare provider/supplier enrollment and revalidation. Many vendors submit PECOS applications on behalf of clients. 

Gather primary-source authentication documents

• Diplomas; board certificates; state license verifications; DEA (if applicable); malpractice insurance; work history 

Develop hospital privileging packets  

• Hospitals need to have privileging documentation separate from commercial payer credentialing..  

• Vendors such as Cactus and CredentialStream help assemble privileging packets. 

Register on Washington Apple Health/Medicaid

• Register with Washington Apple Health (Medicaid). Some provider types require additional forms or enrollment steps. 

Monitoring of sanctions and track revalidation dates

• Monitor sanctions and revalidation dates. Ensure your vendor provides automated reminders and continuous monitoring. 

Final thoughts 

Choose a credentialing partner that understands Washington licensing tools and federal enrollment. Doing so reduces delays and denials. Credex Healthcare offers full-service support, including CAQH, PECOS, payer enrollment, and ongoing monitoring. 

Get Credentialed with Credex Healthcare Today! 

FAQs 

Q: How long does credentialing take in Washington? 
Commercial payer credentialing typically takes 60–120 days, depending on completeness and follow-up. PECOS timelines vary and can be longer. 

Q: What documents are required for provider enrollment? 
Standard documents include: active Washington license (WMC verification), DEA (if applicable), NPI, curriculum vitae, medical education diplomas, board certification (if applicable), malpractice insurance declarations, practice address, and government ID. 

Q: Can telehealth providers get credentialed in Washington? 
Yes. Telehealth providers must hold a Washington license, and payers must accept telehealth services on their panels. Some payers require additional telehealth enrollment details.  

Q: How often should providers revalidate their credentials? 
Most payers require recredentialing every 24–36 months. Medicare has separate revalidation cycles per PECOS/CMS guidance. 

Q: What is the difference between a CVO and an outsourced credentialing service? 
A Credentials Verification Organization (CVO) focuses on primary-source verification. An outsourced credentialing service typically includes CVO verification plus payer enrollment, appeals, and ongoing monitoring. Large health systems often use a CVO for verification and a separate vendor for enrollment.