Provider verification, built for the platforms that depend on it
Primary source verification, continuous sanctions monitoring, and re-credentialing — all in one workspace.
Credentialing was designed for credentialing specialists, not generic HR. Run primary source verification against state license boards, NPI, ABMS, and education and employment sources. Monitor OIG, SAM, and state Medicaid exclusions continuously. Trigger re-credentialing on schedule. Every decision and source captured in a defensible file ready for NCQA, URAC, or delegated audits.
Capabilities
Primary Source Verification
Automated PSV against state license boards, NPI registry, ABMS, AAMC, and education and employment sources, with exception queues for cases that need a human reviewer.
Sanctions & Exclusion Monitoring
Continuous OIG, SAM, state Medicaid, and SDN list checks. Surface hits to a credentialing reviewer the moment they appear, not at the next quarterly sweep.
Re-Credentialing Workflows
Trigger 36-month or facility-specific re-credentialing automatically. Provider self-service attestations and document refresh, no spreadsheet to chase.
Payer Enrollment Support
CAQH-aware data model and roster tooling that keeps payer applications, group affiliations, and effective dates in sync across plans.
Audit-Ready Files
Every verification source, timestamp, and reviewer decision captured in a defensible credentialing file — exportable for delegated audits or accreditation surveys.
Privileging Matrices
Facility-specific requirement matrices that flag gaps before a provider gets assigned, not after a chart review.
Use Cases
- Initial credentialing for new providers
- Re-credentialing on a 36-month cadence
- Continuous OIG, SAM, and state exclusion monitoring
- License and DEA expiration tracking across all 50 states
- Locum reassignment with credential portability
- Delegated credentialing roster maintenance for payers
- CAQH-synced provider profile management
- Audit prep for NCQA, URAC, and Joint Commission
See Credentialing in action
Bring a real workflow and we'll show you exactly how it works.