Credentialing · California (CA) · Family Medicine
Credentialing records in ShtegMed are PHI-free by design — NPI, license, board, and payer identity only — with env-driven source configuration and a deterministic, auditable verdict fold.
Provider roster intake, CAQH attestation check, and document collection. Missing or stale CAQH attestations are the most common cause of downstream delay.
State license boards, DEA registration, and board certification are verified at the primary source. ShtegMed is fail-closed: an unreachable or unconfigured source yields INDETERMINATE — a provider is never assumed verified.
OIG-LEIE, SAM.gov, and NPDB screening with ongoing re-screening. Any blocking hit marks the provider SANCTIONED and stops new settlement advances through the gate.
Per-payer enrollment for claims (EDI) and remittance (EFT). NOT_ENROLLED is surfaced as a non-blocking warning so clean claims are not silently held.
License-expiry windows drive EXPIRING_SOON warnings ahead of lapse, supporting the recredentialing work each reappointment cycle requires.
All durations are typical industry estimates, not guarantees. Actual timelines vary by state board, payer, and completeness of the provider file. ShtegMed surfaces live per-phase status instead of promising a fixed turnaround.
Provider identity only: NPI, license and board records, sanctions-screening postures, and payer enrollment status. It stores no patient data, which keeps the credentialing surface out of PHI scope.
The verdict is INDETERMINATE and treated as blocking (fail-closed). ShtegMed never fabricates a clean verification result from a missing source.