Provider Credentialing, Privileging & Enrollment

MaineHealth is committed to ensuring that every provider is thoroughly credentialed, appropriately privileged and seamlessly enrolled with payors. 

Our credentialing verification organization (CVO), medical staff services (MSS) and provider enrollment services (PES) teams collaborate to support providers across every stage of their onboarding and ongoing credentialing lifecycle. 

Together, we deliver a streamlined, supportive experience that reduces administrative burden and allows providers to focus on patient care.

Credentialing verification organization (CVO)

The CVO is a trusted partner in the provider onboarding process. We perform comprehensive primary source verification of education, training, licensure, and professional history in accordance with state regulations and the rigorous standards set by the National Committee for Quality Assurance (NCQA), the Accreditation Association for Ambulatory Health Care (AAAHC), and The Joint Commission (TJC). 

Staffed by certified medical services professionals, our CVO team delivers a blend of technical expertise and responsive service to support provider readiness and regulatory compliance.

Services

  • Primary source verification of provider credentials
  • Maintenance of credentialing records
  • Support for initial and recredentialing processes​ 

Contact

Medical staff services (MSS)

The MSS team ensures that all MaineHealth physicians and advanced practice providers are appropriately privileged and supported in their medical staff roles. We collaborate with hospital leadership, department chairs, and committees to maintain compliance with The Joint Commission, CMS, and state regulatory bodies. 

In addition, MSS coordinates medical staff governance, supports committee operations and maintains documentation to uphold the integrity of clinical practice across the system.

For inquiries related to privileging and medical staff services, please contact:

Hospital affiliation verifications

Please use our CredentialStream verification portal to confirm a provider’s affiliation with a MaineHealth hospital or medical center.

Provider enrollment services (PES)

The PES team facilitates timely and accurate insurance enrollment for MaineHealth providers. We manage the submission of enrollment applications, credentialing verification with payors, and ensure providers are correctly linked to MaineHealth across commercial insurers, Medicare and Medicaid. 

Our work reduces administrative delays, supports timely reimbursement and helps providers begin practicing without disruption.

Services

  • Assistance with payor enrollment applications
  • Guidance on enrollment requirements and timelines
  • Liaison between providers and insurance companies​

Contact

  • Email: PES@mainehealth.org
  • Phone: 207-661-5490
  • Fax: 207-661-8523
  • Mailing Address:
    MaineHealth PES
    1 Riverfront Plaza
    Westbrook, ME 04092