Medwave Billing & Credentialing
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Credentialing, Contracting, & Billing
Call or Text: (412) 219-4789

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.

Revenue slips away after the patient leaves. A denied claim needs rework before it pays, and a contract set below market rates shorts the practice on every claim that follows.

Our credentialing team manages provider enrollment with Medicare, Medicaid, and commercial payers from initial application through approval, tracking every deadline and following up on every pending status so your providers can see patients and get paid without unnecessary gaps. We also handle recredentialing cycles and CAQH profile maintenance so nothing lapses.

On the contracting side, we review your current payer agreements, identify rates that are below market, and negotiate directly with payers on your behalf. Most practices have never had their contracts systematically reviewed, which means they are collecting less than they should be on every single claim.

Our billing team handles charge capture, coding review, claim submission, payment posting, and denial management. We work across specialties and practice types, and we do not outsource the work overseas. Every account is managed by experienced billing staff who understand how to push back on payers when claims are wrongly denied.

Medical Credentialing

medical credentialing expert

Medwave manages provider 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

payer contracting expert

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

medical billing expert reviewing claims

We handle medical billing for practices across the country, including charge capture, claim submission, denial management, payment posting. HL7 integration and RPA for billing automation, reducing manual work, accelerating 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 the full revenue cycle stays visible in real time without adding administrative headcount.

Medwave is based in Cranberry Township, Pennsylvania, and works with medical practices nationally, across the United States, on credentialing, payer contracting, rate negotiations, and medical billing. Whether you need support with a single service or want a team managing your full revenue cycle, we work the way your practice needs.

Services

  • Medical Credentialing
  • Recredentialing
  • Payer Contracting
  • Rate Negotiations
  • Medical Billing
  • Telehealth Billing
  • Denial Management
  • A/R Recovery
  • Revenue Cycle Consulting

Resources

  • CAQH ProView Form
  • On-Boarding Documentation Checklist
  • Credentialing Use Cases
  • Credentialing Turnaround
  • Blog
  • FAQ
  • Videos
  • Podcast
  • Glossary of Terms

Recent Posts

  • Blue Cross Blue Shield (bcbs) Credentialing

    BCBS Credentialing by State: What Changes and What Doesn’t

  • Management Service Organization (mso) Ceo

    Management Services Organizations: What Private Practices Need to Know Before Signing

  • Payer Contracting Scene. a Provider and Payer.

    In-Network vs. Out-of-Network Contracting: Which Pays More for Your Specialty?

  • Provider Credentialing Specialist

    Why You Can’t Bill What You Can’t Credential

  • Full-cycle Medical Credentialing Support Expert

    Affordable, Full-Cycle Credentialing: Why the Price Drops the More You Buy

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