Credentialing Healthcare Providers

Delegated Credentialing

Designed specifically to support health plans that delegate credentialing of providers to hospitals, IPAs or other provider groups. CredSimple provides a complete delegated credentialing and provider data management solution that exceeds the NCQA credentialing requirements, including medical board certification verification.

  • Roster Manager

    The CredSimple platform makes it easy to keep all of your roster information organized and up to date. Our online database helps you to manage inbound rosters with new or terminated providers and roster updates with changes to address and billing information.

  • Monitor Delegated Providers

    Even if you have delegated providers, you still need to stay ahead of important quality and safety issues in your network through robust ongoing monitoring. When a provider is added to CredSimple, they are monitored for federal and state level sanctions and board actions.

  • Update Billing and Provider Data

    The provider data collected in the credentialing process is powerful, so use it to its full potential. CredSimple cleans, validates, and structures provider data, then exports it for use in downstream systems like claims and provider directories. Reduce costs and errors and improve member experience.

  • Easy-to-Use Healthcare Software

    Our powerful technology is extremely simple to use and when combined with our award-winning Data Services Team ensures that your implementation and use of our software is easy and smooth. No additional IT resources are required to run your operations with confidence and maximize the quality of your data and the speed of your business processes.

Complete Delegated Credentialing Solution

We handle the implementation

We’ve met or exceeded 100% of our customers’ implementation expectations.

Protect your information

We use 256-bit encryption and Secure Socket Layer (SSL) technology to protect your provider data.

NCQA Compliance

Primary source verifications meet NCQA and JCAHO standards, and audit trails track every change.

Advanced security

Our advanced security measures have passed the stringent security audit requirements of AMA and ABMS.