Provider credentialing and payer enrollment: primary-source verification, sanctions screening, and enrollment tracking — wired into the settlement path rather than run as a side process.
Deterministic architecture, governed by explicit compliance gates.
Every clinical and financial surface is built on a hash-chained WORM double-entry ledger, a six-condition settlement gate, and an integer-cent 835 reconciliation waterfall under a registered HIPAA clearinghouse and Type-2 organizational NPI. Integrations without active counterparty credentials or executed BAAs fail closed by contract.
Credentialing is a gate condition here, so each step has to produce something the settlement path can act on.
Licenses, board certification, education and work history verified against the issuing source rather than a copy supplied by the applicant.
Continuous OIG-LEIE, SAM and NPDB screening, with NPPES registry checks — so an exclusion is caught when it lands, not at the next re-credentialing cycle.
Enrollment status per payer per provider, with the expirables that drive re-credentialing tracked on the same record.
Provider legitimacy is a settlement-gate condition, not a report. A provider who fails screening cannot have a claim settled on their behalf.
Process guides covering the steps, the usual sequence, and what drives the timeline. Written per state because the sequence genuinely differs.
If that is the posture you want under your revenue, the next step is a conversation — not a checkout.