Medical Credentialing, Payer Contracting, and Billing for Independent Practices

Medwave provides medical credentialing, payer contracting, and medical billing for independent practices, group practices, allied health providers, and multi-specialty organizations across the United States. Medwave has supported more than 15,000 providers, maintains a 98% clean claim rate, and averages 85 days for credentialing turnaround. Medwave is HIPAA compliant.

Getting paid starts well before the first claim goes out. A provider who isn’t credentialed with a payer can’t be reimbursed by that payer, and a contract signed below market rates shorts the practice on every claim that follows. Denials that sit unworked drain whatever is left.

Medwave covers all three. We stay on each application or contract until it’s complete. For the practices we take on for billing, experienced billers push back on wrongly denied claims across specialties and practice types. Every part of this work is done in-house by Medwave staff, and none of it is outsourced overseas.

Medical Credentialing

Medwave manages medical credentialing for healthcare practices across the country, including initial enrollment, CAQH setup, payer-specific applications, and revalidation tracking. We have credentialed providers across most specialties for over 25 years.

Credentialing Simplified

Payer Contracting

Most payer contracts are signed once and never revisited. Medwave reviews your existing contracts, identifies where you are being underpaid by CPT code, and negotiates better rates directly with payers on your behalf using your own claims data.

Payer Contract Review

Medical Billing

We handle medical billing for practices across the country, including charge capture, claim submission, denial management, and payment posting, with HL7 integration and RPA for billing automation to reduce manual work and speed up payment timelines.

Better Billing Workflows

How Our Credentialing Process Works

Credentialing starts with onboarding, where Medwave gathers every required document from the provider. The timeline begins once those documents are complete and submitted to the payer, and Medwave averages 85 days on that timeline. Our team handles provider credentialing through deficiency requests and payer follow-up until the application is approved, and stays on for recredentialing after that. Practices that would rather not run the process in-house can read why outsource your credentialing before deciding.

How We Negotiate Payer Contracts and Reimbursement Rates

Medwave benchmarks every fee schedule against Medicare and peer market rates using your own claims data, which shows exactly which CPT codes pay below market. That analysis becomes a documented case, and Medwave negotiates rate improvements with commercial payers before anything is signed or renewed. Contract language gets the same scrutiny, including termination clauses, timely filing provisions, and audit rights that create liability for providers who sign payer contracts without reading them. Our payer contract analysis guide shows how to evaluate rates, payment terms, and contract risk on your own.

How Our Billing Team and Technology Handle Your Claims

Medwave’s billing service pairs experienced staff with RPA billing automation for the high-volume work, including eligibility checks, claim submission, and payment posting. Automating those steps cuts manual entry errors and speeds up claim turnaround. Practices that need two-way data exchange with their EHR get it through HL7 standards, and claim and payment activity stays visible in real time without adding administrative headcount.