Provider Credentialing, Privileging & Enrollment

The MaineHealth Credentialing department is a trusted partner in provider onboarding and ongoing credentialing support. We conduct comprehensive primary source verification of education, training, licensure, certification and professional history in alignment with state regulations and nationally recognized accreditation standards, including:

  • National Committee for Quality Assurance (NCQA)
  • Accreditation Association for Ambulatory Health Care (AAAHC)
  • Centers for Medicare & Medicaid Services (CMS)
  • The Joint Commission (TJC)

Staffed by certified medical professionals, our credentialing team delivers consistent, accurate and timely services that support provider readiness, patient safety and continuous regulatory compliance across the MaineHealth system.

Credentialing services

  • Primary source verification of provider credentials
  • Maintenance of credentialing records
  • Support for initial and recredentialing processes​
  • Ongoing monitoring support in accordance with regulatory requirements

Contact

Medical staff services

The MaineHealth Medical Staff Services (MSS) department supports the integrity of clinical practice by ensuring physicians and advanced practice providers are appropriately credentialed, privileged and supported in accordance with governing documents and regulatory requirements.

The MSS team partners closely with hospital leadership, department chairs and medical staff committees to maintain compliance with The Joint Commission, CMS and applicable state regulations. In addition to privileging support, the MSS team coordinates medical staff governance, committee operations and official documentation to promote consistent, defensible, decision-making across the system. Services include:

  • Provider privileging and re-privileging support
  • Medical Staff governance and committee coordination
  • Maintenance of Medical Staff records and official documentation
  • Regulatory and accreditation readiness support

MSS contacts

For questions about medical staff privileging or governance, 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