provider credentialing

ALPS Services, Inc. (American Loss Prevention Services) is a Service-Disabled Veteran-Owned Small Business founded in 1987 that specializes in Medical Quality and Cost Control consulting. It provides comprehensive medical cost control services including utilization management, cost control, and quality assessment across all health care settings, and primarily works with prime contractors on state and federal contracts as well as health care insurers.

case managementclaims auditclaims processingcoding and DRG validationCost Controlmedical bill reviewmedical record abstractionmedical record reviewquality assessmentsubrogationutilization management

Assurgent Medical Billing Solutions is a full-service Revenue Cycle Management company serving medical practices. Founded by Christa Holloway, a Revenue Cycle Strategist with over 17 years of experience in medical billing, the company focuses on identifying lost revenue, reducing denials, and strengthening the systems that impact reimbursement. It goes beyond claim submission to address root causes of delayed, denied, and underpaid claims.

Accounts Receivable Recoveryclaims auditingcodingDenial Resolutioninsurance contractinginsurance verificationPayer Strategy Consultingpayment postingreportingrevenue cycle management

CHB Medical Billing (Certified Healthcare Billing) is a California-based, US-based medical billing and revenue cycle management company serving physician practices across the USA. It provides end-to-end RCM including medical billing, medical coding, denial management, AR follow-up, payment posting, and provider credentialing. The company states it is HIPAA-compliant and undergoing a SOC 2 Type II audit, and has accumulated California medical billing experience since 2002.

AR follow-upclaim submissiondenial managementEHR integrationeligibility verificationERA postingMedical billingMedical Codingpayment postingrevenue cycle management

CredNet (Credential Network) provides an AI-native platform for healthcare credentialing and payer enrollment, designed to replace spreadsheets and legacy software for organizations from solo clinics to multi-state health systems. Its platform includes CredComply, an admin dashboard for credentialing and payer enrollment, and CredWallet, a free credential wallet mobile app for providers. It is SOC 2 Type II and HIPAA compliant.

AI document parsing and extractionaudit-ready reporting and document managementautomated expiration alerts and renewalsexclusion and sanction list monitoringfacility credentialing and privileginggroup credentialingnative integrations with NPI, OIG, SAM, state license boards, and DataSpring (CAQH)payer enrollmentwhite labeling

Acentra Health provides an Employee Assistance Program (EAP) and Worklife solution, previously named Kepro. The program offers confidential counseling, worklife, legal and financial, management, critical incident, training, and online services, with access 24/7, 365 days a year. It has more than 25 years of experience and is a two-time recipient of the EAPA Award for Excellence.

counselingcritical incident responselegal and financial consultationmanagement consultationonline resourcestrainingworklife consulting

Emperion is a URAC-accredited Independent Medical Examination (IME) and review organization serving Workers' Compensation, Automobile, Disability, and Health benefit systems. With 48+ years of expertise, 25,000+ medical provider locations across all specialties, and four regional service centers, it delivers independent medical exams, peer reviews, functional capacity evaluations, and fitness-for-duty assessments. Every report goes through quality assurance review.

Conflict-of-interest screeningFitness-for-duty evaluationsfunctional capacity evaluationsindependent medical examinationspeer reviewsquality assurance review

Essential HealthCare Solutions, LLC (EHS) is a national healthcare management and staffing company founded in 2015. It is a woman-owned small business with Federal, State and Local Government contracting experience, providing healthcare consulting, provider network development, credentialing, claims adjudication, and medical and behavioral health staffing.

claims adjudicationcontract negotiationsCOVID testing supportemergency disaster rapid medical staffinghealthcare managementmedical and behavioral health staffingmedical supply and equipment procurementPPE procurementprovider network development

Evolent specializes in connecting care for people with complex conditions, working across specialties and primary care to improve the care journey for patients with cancer, cardiovascular diseases, musculoskeletal disorders, and other conditions. Its solutions span multiple medical specialties, offering health plans the potential to improve health outcomes and affordability across the member experience.

actuarial servicesBehavioral Healthcare managementclaims processingclinical pathwayscontact center servicesdata managementdecision supportencounters managementenrollment and eligibilitymedical economics analyticsMSO for delegated provider servicesPharmacy Benefit Managementpopulation health managementprovider/patient engagementrisk adjustment and quality

Healthcare Billing360 LLC is a medical billing company located in Akron, OH. It provides comprehensive billing solutions for home health agencies, private practices, and healthcare organizations, including accurate claims processing, revenue cycle management, and compliance support. The company also offers provider credentialing, compliance and healthcare consulting, and medical billing training programs.

AR follow-upclaims processingcompliance consultingdenial managementhealthcare startup consultingMedical billingMedical Codingrevenue cycle managementtraining programs