← Readiness queue
PRV-4003
BlockedSynthetic provider file · no real PII / no PHICRNA · Anesthesia · TRH Main — Surgery
Weighted readiness
80
5/6 checks verified
Deadline
6d over
Enrollment overdue (Aetna)
Flags
1 blockingexclusion clear
Primary-source verification checklist
| Dimension | Status | Detail | Primary source | Weight |
|---|---|---|---|---|
| State license (APRN) | Verified | Active | BON primary source (batch PSV) | 25% |
| DEA registration | Verified | Active | DEA CSA registry (batch) | 15% |
| Certification (NBCRNA) | Verified | Current | NBCRNA (batch) | 15% |
| Payer enrollment (Aetna) | Exception | Enrollment lapsed — billing hold risk | Aetna enrollment export | 20% |
| OIG-LEIE / SAM exclusion | Verified | No match on last batch screen | OIG-LEIE + SAM.gov (batch) | 15% |
| Malpractice coverage | Verified | Current | COI on file | 10% |
Evidence provenance
- Owner
- R. Okafor
- Evidence
- Credentialing packet PRV-4003 · PSV batch 06-30
- Linked agreement
- Commercial Payer Participation Agreement
Readiness workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-06-18 — PRV-4003 surfaced by VERIFY readiness rule from the Credentialing + PSV batch extract · FY2026 Q3.
- seed2026-06-18 — Primary-source verification results reconciled against agreement scope and payer enrollment.