For Health and Dental Plans
Clean provider files, without the chase.
Your enrollment team spends its days emailing providers for the missing license copy, the current address, the signature on page nine. Files that come through PayerReady arrive complete: maintained by the provider at the source, verified on our platform, and current on the day you open them.
Complete on arrival
No back and forth to finish a file
Files that arrive finished
Watch three provider files land in your intake: license verified, demographics current, documents complete. Nothing for your team to chase.
What your enrollment team receives
Real screens from the platform where the files live.
The whole professional record, one profile
NPI, DEA, education and training, practice locations, malpractice coverage, and every supporting document, held in one provider profile and kept current by the person who knows it best. Group contracts pull entity data (Tax ID, organizational NPI, certificates) from the same verified place.
- Demographics maintained by the provider at the source
- Documents attached to the record, not an inbox
- Entity data for group enrollment in one location
Directory accuracy is now a regulatory clock
The No Surprises Act put provider directories on a 90 day verification cycle. Stale spreadsheets stopped being an inconvenience and became a compliance finding.
The 90 day verification cycle
Federal rules expect plan directories to verify provider information every 90 days and remove entries that cannot be confirmed. Meeting that cadence with outbound phone and fax campaigns is expensive and lossy. Meeting it with provider maintained source data is structural.
Incomplete files stall committees
Every application that arrives missing a license copy or carrying a lapsed attestation consumes a full correspondence cycle before your credentialing committee can even calendar it. Files that arrive complete keep committee throughput predictable and turnaround statistics defensible.
Network integrity between recredentialing cycles
A three year recredentialing cycle leaves long dark stretches where a license can lapse unnoticed. Files maintained on PayerReady carry continuous expiration tracking and scheduled exclusion screening, so the network picture your members rely on stays true between formal reviews.
What arrives with every file
Six guarantees your enrollment team can build a process on.
Source-maintained demographics
Addresses, phone numbers, practice locations, and panel details updated by the provider who owns them, not transcribed by a third party months later.
Professional identifiers, verified
NPI, DEA, state license numbers, and taxonomy codes held on the profile with source documents attached, ready for primary source verification workflows.
Education and training history
Medical school, residency, fellowship, and board certification records structured consistently across every file instead of arriving as fifteen different resume formats.
Complete document sets
Licenses, DEA certificates, malpractice face sheets, CVs, and W-9s attached to the record with expiration dates read and tracked by Document AI.
Entity and group data
Tax IDs, organizational NPIs, and entity certificates held in the Organization Profile for group contracts and roster submissions, verified once and reused.
Continuous status, not snapshots
License standing, CAQH attestation currency, and exclusion screening results reflect today. The file you open is the file as it exists, not as it was last keyed.
For plan enrollment teams
What clean intake changes
Files built and maintained at the source change the arithmetic of your entire queue.
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verified profile per provider
No competing versions across inboxes, spreadsheets, and last year’s roster submission.
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chase emails to complete a file
Complete on arrival is a property of the pipeline, not a service level promise.
0/60/30
day expiration tracking, continuous
License status reflects today, not the date the file was first keyed into a system.
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of the credentialing decision stays yours
Your committee, your standards, your authority. We only guarantee the inputs.
Plan questions, answered straight
What enrollment and network teams ask us first.
Providers manage their own profiles: addresses, contact info, practice locations. Since they update it at the source, the data your team receives is current instead of copied from last year's spreadsheet. That is the difference between directory accuracy by policy and directory accuracy by construction.
Personal information, professional identifiers like NPI and DEA, education and training history, practice locations, and all supporting documents. Everything your enrollment team needs arrives in one complete profile.
Yes. The Organization Profile stores the entity's Tax ID, organizational NPI, and certificates in one verified location. This is what your team pulls for group enrollment and network contracts.
The platform shows every provider's license status in one view: active, expired, or pending renewal. Expiration tracking runs continuously, so the file you receive reflects today, not the day it was first typed.
No. Your credentialing committee keeps full authority. We deliver the complete, verified data package so the file that reaches your team is clean, current, and ready to review without the usual back and forth.