Workforce — credentialing & enrollment readiness
Provider credentialing, payer enrollment, licensure, and OIG-LEIE / SAM exclusion screening for TRH's medical staff. Provider files are fully synthetic (PRV-#### / NPI-DEMO-####) — no real practitioner names, NPIs, or PII.
Data source: Credentialing + PSV batch extract · FY2026 Q3. Periodic batch — primary-source verification and OIG-LEIE/SAM exclusion screens are run on a schedule, not a real-time feed. Next scheduled screen: July 26, 2026.
Credentialing & enrollment worklist
Review, clear, or place a billing hold. Open any file for the full primary-source verification checklist, exclusion screen, evidence provenance, and chronology. Ordered by deadline urgency.
| Provider file | Role / specialty | Readiness | Deadline | Flags | Status | Actions |
|---|---|---|---|---|---|---|
| PRV-4003 NPI-DEMO-4003 · TRH Main — Surgery | CRNA Anesthesia | 80 5/6 verified | 6d overdue Enrollment overdue (Aetna) | 1 blocking | Blocked | |
| PRV-4005 NPI-DEMO-4005 · TRH — Imaging (contracted) | Radiologist (tele) Radiology | 86 4/6 verified | 9d Privilege renewal due 2026-07-21 | 2 attentionexclusion check | Action needed | |
| PRV-4001 NPI-DEMO-4001 · TRH Main — Surgery | Attending physician Orthopedic surgery | 83 4/6 verified | 21d Recredential due 2026-08-02 | 2 attention | Action needed | |
| PRV-4004 NPI-DEMO-4004 · TRH Main — ED | Emergency physician Emergency medicine | 88 4/6 verified | 44d Recredential due 2026-08-25 | 2 attention | In review | |
| PRV-4002 NPI-DEMO-4002 · TRH Main — Medicine | Hospitalist Internal medicine | 100 6/6 verified | 118d Recredential due 2026-11-07 | clear | Ready | |
| PRV-4006 NPI-DEMO-4006 · TRH Main — Women's | Certified nurse midwife OB/GYN | 100 6/6 verified | 155d Recredential due 2026-12-14 | clear | Ready |
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Weekly readiness review
What the VERIFY technology identifies from the credentialing extract and batch screens, what HARS Advisors validate, what TRH owners decide, and what gets reviewed each cycle.
- ›Files approaching recredential / enrollment deadlines from the batch extract
- ›Expiring licenses, DEA, board certs, and malpractice coverage
- ›OIG-LEIE / SAM exclusion-screen matches and enrollment lapses
- ›Whether a flagged exclusion match is a true positive before any action
- ›Root cause of enrollment lapses (payer backlog vs. missing submission)
- ›Which files are genuinely blocked for billing vs. simply in review
- ›Which at-risk files to expedite this week
- ›When to place a billing hold pending enrollment reinstatement
- ›Escalation to the Medical Staff Office / payer provider rep
- ›Readiness score movement and files cleared vs. prior week
- ›Overdue and due-soon deadline counts
- ›Open exclusion flags and their owners
No PHI and no real provider PII is shown or stored. Provider identifiers are synthetic (6 demo files). Exclusion screening and primary-source verification are periodic batch processes — this module is not a real-time license or exclusion feed.