← Readiness queue
PRV-4001
Action neededSynthetic provider file · no real PII / no PHIAttending physician · Orthopedic surgery · TRH Main — Surgery
Weighted readiness
83
4/6 checks verified
Deadline
21d
Recredential due 2026-08-02
Flags
2 attentionexclusion clear
Primary-source verification checklist
| Dimension | Status | Detail | Primary source | Weight |
|---|---|---|---|---|
| State medical license | Verified | Active, no board actions | TMB primary source (batch PSV) | 25% |
| DEA registration | Expiring | Expires 2026-09-15 — renewal not yet filed | DEA CSA registry (batch) | 15% |
| Board certification | Verified | ABOS current through 2028 | ABMS (batch) | 15% |
| Payer enrollment (UHC) | Pending | Revalidation submitted, awaiting payer | UHC enrollment portal export | 20% |
| OIG-LEIE / SAM exclusion | Verified | No match on last batch screen | OIG-LEIE + SAM.gov (batch) | 15% |
| Malpractice coverage | Verified | Current, limits meet bylaws | COI on file | 10% |
Evidence provenance
- Owner
- L. Nguyen
- Evidence
- Credentialing packet PRV-4001 · PSV batch 06-30
- Linked agreement
- Commercial Payer Participation Agreement
Readiness workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-06-30 — PRV-4001 surfaced by VERIFY readiness rule from the Credentialing + PSV batch extract · FY2026 Q3.
- seed2026-06-30 — Primary-source verification results reconciled against agreement scope and payer enrollment.