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Credentialing Workflows Export

Data dictionary for the practitioner credentialing-workflows Excel export. Every column produced by the export, grouped by the Excel tab (section) it appears on. All unnested tabs carry workflow_id and entity_npi as join keys back to Main_Workflow_Data.

Schema
29 tabs317 fields

Showing 317 of 317 fields · 29 tabs

Main_Workflow_Data 40 fields

FieldTypeDescription
organization_nameSTRINGName of the client tenant/organization the workflow belongs to (e.g. a health plan name).
entity_npiSTRINGPractitioner's National Provider Identifier. Join key used across every other tab.
practitioner_prefixSTRINGPractitioner's name prefix/title (e.g. Dr.).
practitioner_first_nameSTRINGPractitioner's first name.
practitioner_middle_nameSTRINGPractitioner's middle name.
practitioner_last_nameSTRINGPractitioner's last name.
practitioner_suffixSTRINGPractitioner's name suffix (e.g. Jr., MD).
entity_full_nameSTRINGFirst, middle, and last name concatenated with spaces (blank parts omitted).
practitioner_external_idSTRINGExternal/client-supplied identifier for the practitioner.
practitioner_primary_emailSTRINGPractitioner's primary email address.
practitioner_genderSTRINGPractitioner's recorded gender.
practitioner_raceSTRINGPractitioner's recorded race.
practitioner_ethnicitySTRINGPractitioner's recorded ethnicity.
practitioner_is_deceasedBOOLEANWhether the practitioner is recorded as deceased.
practitioner_deceased_dateDATEDate of death, if recorded.
practitioner_deceased_explanationSTRINGFree-text explanation/source for the deceased flag.
entity_created_atDATEDate the practitioner record was created in the tenant's network.
practitioner_initial_credentialing_dateDATEDate of the practitioner's first (initial) credentialing.
practitioner_last_credentialed_dateDATEDate the practitioner was most recently credentialed.
practitioner_next_credentialing_dateDATEDate the practitioner's next (re)credentialing is due.
practitioner_attestation_dateDATEDate of the practitioner's most recent attestation.
practitioner_reimbursement_idSTRINGReimbursement/billing identifier for the practitioner.
practitioner_supervising_practitioner_idSTRINGIdentifier of the practitioner's supervising practitioner, if applicable.
practitioner_caqh_provider_idSTRINGPractitioner's CAQH provider ID; used to join to the CAQH roster for outreach-blocker reporting.
practitioner_typesSTRINGComma-separated list of distinct, nonblank practitioner types recorded across the practitioner's licenses.
degreesSTRINGComma-separated list of distinct, nonblank degrees recorded across the practitioner's education and training entries.
group_nameSTRINGProvider group name associated with the practitioner workflow, when supplied.
workflow_idSTRINGUnique identifier of the credentialing workflow. Primary join key linking this tab to every unnested tab below.
workflow_created_atDATEDate the credentialing workflow was created.
workflow_latest_statusSTRINGMost recent credentialing status/step name for the workflow (e.g. PSV_READY, CRED_APPROVED, WITHDRAWN_CANCELLED), derived from the latest timeline event.
workflow_latest_status_dateDATEDate the workflow entered its most recent (latest) status.
credentialing_cycleSTRINGCredentialing cycle type (e.g. Initial, Annual/Recredentialing).
credentialing_due_dateDATEDate by which credentialing/recredentialing is due.
previous_credentialed_dateDATEDate of the practitioner's prior credentialing cycle.
line_of_businessSTRINGComma-separated, alphabetically sorted list of the practitioner's lines of business.
states_to_credentialSTRINGComma-separated, alphabetically sorted list of state abbreviations the practitioner is being credentialed in.
file_typeSTRINGMost recent file-type classification for the practitioner (e.g. Clean, Dirty); defaults to "Unassigned" if never set.
file_type_reasonSTRINGReason associated with the most recent file_type change; defaults to "Unassigned".
application_received_dateDATEDate the credentialing application was received (workflow creation date).
application_completion_dateDATEComputed date the application was completed, sourced from the providerhub_reporting.application_complete_date dbt model: the last practitioner response date (inbound email or CAQH attestation) before the credentialing decision when a Section B (file-incomplete) outreach reason was raised; otherwise the workflow creation date. Always NULL in Open Workflow report files (report_type=open), since the application cannot be complete while the workflow is still open. In Terminal files, NULL only if the workflow has no matching row in that model.

Emails 5 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
emailSTRINGEmail address on file for the practitioner.
email_typeSTRINGCategory of the email address (e.g. work, personal).
email_sourceSTRINGSystem/process that sourced or verified this email record.

Phone_Numbers 6 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
phone_numberSTRINGPractitioner's phone number.
fax_numberSTRINGPractitioner's fax number.
phone_typeSTRINGCategory of the phone number (e.g. office, mobile).
phone_sourceSTRINGSystem/process that sourced this phone record.

Addresses 10 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
address1STRINGStreet address line 1.
address2STRINGStreet address line 2.
citySTRINGCity.
stateSTRINGState/territory abbreviation.
countrySTRINGCountry.
zipcodeSTRINGPostal/ZIP code.
address_typeSTRINGType of address (e.g. mailing, home, practice).
sourceSTRINGSystem/process that sourced this address record.

Licenses 16 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
license_numberSTRINGState license number.
license_number_variationsSTRINGAlternate/historical spellings or formats of the license number.
stateSTRINGState that issued the license.
license_statusSTRINGCurrent status of the license (e.g. Active, Inactive).
license_typeSTRINGType/category of license (e.g. MD, DO, NP).
license_sourceSTRINGPrimary-source system used to verify the license.
practitioner_typeSTRINGPractitioner type associated with this license record.
specialtySTRINGSpecialty associated with this license.
expirationDATELicense expiration date.
issue_dateDATEDate the license was issued.
verified_dateDATEDate the license was last primary-source verified.
board_action_flagBOOLEANWhether a board/disciplinary action is flagged against this license.
urlSTRINGURL to the primary-source verification record.
expiration_statusSTRINGComputed status derived from `expiration`: "No Expiration", "EXPIRED", "Expiring Soon" (<=60 days), or "Active".

Board_Certifications 20 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
certificate_idSTRINGIdentifier of the board certificate.
certificate_typeSTRINGType of certificate (e.g. board certification).
certifying_board_nameSTRINGName of the certifying board (e.g. ABMS member board).
duration_typeSTRINGCertification duration classification (e.g. time-limited vs. lifetime).
specialitySTRINGCertified specialty (source field name, note UK spelling).
subspecialitySTRINGCertified subspecialty (source field name, note UK spelling).
expiration_dateDATECertification expiration date.
expire_dateDATESecondary/raw expiration date field from the source system (may duplicate expiration_date).
issue_dateDATEDate the certification was issued.
verified_dateDATEDate the certification was last primary-source verified.
report_dateDATEDate the certification was reported by the primary source.
flagged_dateDATEDate the certification was flagged for review, if applicable.
is_primaryBOOLEANWhether this is the practitioner's primary board certification.
mocSTRINGMaintenance of Certification (MOC) status/indicator.
occurance_typeSTRINGOccurrence/record type classification (source field name, note spelling).
record_typeSTRINGType of certification record.
sourceSTRINGSystem/process that sourced this certification record.
cert_statusSTRINGCurrent status of the certification.

Education_Training 14 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
typeSTRINGType of education/training record (e.g. Medical School, Residency, Fellowship).
degreeSTRINGDegree earned (e.g. MD, DO).
institutionSTRINGName of the educational institution.
specialitySTRINGSpecialty associated with the training (source field name, note UK spelling).
subspecialtySTRINGSubspecialty associated with the training.
start_dateDATEStart date of the education/training period.
end_dateDATEEnd date of the education/training period.
verified_dateDATEDate the record was last primary-source verified.
statusSTRINGStatus of the education/training record.
sourceSTRINGSystem/process that sourced this record.
source_update_dateDATEDate the source record was last updated.
licensing_board_referenceSTRINGReference identifier used by a licensing board for this record.

Specialties 9 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
typeSTRINGType of specialty record.
specialtySTRINGPractitioner's specialty.
subspecialtySTRINGPractitioner's subspecialty.
primary_specialtyBOOLEANWhether this is the practitioner's primary specialty.
verified_dateDATEDate the specialty was last primary-source verified.
sourceSTRINGSystem/process that sourced this record.
source_update_dateDATEDate the source record was last updated.

Practice_Locations 23 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
address1STRINGPractice location street address line 1.
address2STRINGPractice location street address line 2.
address3STRINGPractice location street address line 3.
address4STRINGPractice location street address line 4.
citySTRINGPractice location city.
stateSTRINGPractice location state.
countrySTRINGPractice location country.
countySTRINGPractice location county.
zipcodeSTRINGPractice location ZIP/postal code.
npiSTRINGNPI of the practice location/facility (distinct from the practitioner's own NPI).
telephone_numberSTRINGPractice location phone number.
fax_numberSTRINGPractice location fax number.
healthcare_service_nameSTRINGName of the healthcare service/facility at this location.
start_dateDATEDate the practitioner began practicing at this location.
clia_numberSTRINGCLIA certificate number for the location's lab, if applicable.
clia_expiration_dateDATEExpiration date of the location's CLIA certificate.
drawing_bloodBOOLEANWhether the location performs blood draws.
laboratory_servicesBOOLEANWhether the location offers laboratory services.
phone_coverage24x7BOOLEANWhether the location provides 24/7 phone coverage.
total_location_hoursFLOATTotal weekly hours the location is open.
verified_dateDATEDate the practice location was last primary-source verified.

Hospital_Affiliations 12 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
nameSTRINGName of the affiliated hospital.
stateSTRINGState the hospital is located in.
specialtySTRINGSpecialty associated with the affiliation.
typeSTRINGType of affiliation (e.g. admitting privileges, staff).
is_primaryBOOLEANWhether this is the practitioner's primary hospital affiliation.
start_dateDATEDate the affiliation began.
end_dateDATEDate the affiliation ended, if applicable.
verified_dateDATEDate the affiliation was last primary-source verified.
statusSTRINGCurrent status of the affiliation.
sourceSTRINGSystem/process that sourced this record.

Malpractice_Insurance 14 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
carrier_nameSTRINGName of the malpractice insurance carrier.
policy_numberSTRINGInsurance policy number.
typeSTRINGType of coverage (e.g. occurrence, claims-made).
effective_dateDATEDate the policy became effective.
expiry_dateDATEDate the policy expires.
aggregate_coverage_amountFLOATAggregate (annual total) coverage amount, in dollars.
occurrence_coverage_amountFLOATPer-occurrence coverage amount, in dollars.
unlimited_coverageBOOLEANWhether the policy provides unlimited coverage.
verified_dateDATEDate the policy was last primary-source verified.
statusSTRINGCurrent status of the policy.
sourceSTRINGSystem/process that sourced this record.
expiration_statusSTRINGComputed status derived from expiry_date: "EXPIRED", "Expiring Soon" (<=60 days), or "Active".

DEA 17 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
dea_numberSTRINGDEA registration number.
numberSTRINGRaw DEA number field from the source system (may duplicate dea_number).
stateSTRINGState associated with the DEA registration.
typeSTRINGType of DEA registration.
provider_typeSTRINGProvider type classification for the registration.
expiration_dateDATEDEA registration expiration date.
expire_dateDATESecondary/raw expiration date field from the source system.
report_dateDATEDate the registration was reported by the primary source.
flagged_dateDATEDate the registration was flagged for review, if applicable.
affiliationSTRINGBusiness/practice affiliation on the registration.
cds_license_numberSTRINGAssociated state Controlled Dangerous Substances (CDS) license number.
verified_dateDATEDate the registration was last primary-source verified.
statusSTRINGCurrent status of the registration.
sourceSTRINGSystem/process that sourced this record.
urlSTRINGURL to the primary-source verification record.

NPDB_Reports 13 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
report_typeSTRINGNational Practitioner Data Bank report type.
type_of_actionSTRINGType of action reported.
allegation_natureSTRINGNature of the underlying allegation.
specific_allegationSTRINGSpecific allegation text/code.
specific_allegation_dateDATEDate of the specific allegation.
allegations_descriptionSTRINGFree-text description of the allegations.
procedure_descriptionSTRINGDescription of the procedure involved, if applicable.
outcomeSTRINGOutcome/resolution of the report.
payment_dateDATEDate of any associated payment.
verified_dateDATEDate the report was last primary-source verified.
sourceSTRINGSystem/process that sourced this record.

Sanctions 8 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
date_of_reportDATEDate the sanction was reported.
sanction_typeSTRINGType of sanction (e.g. exclusion, suspension).
type_of_actionSTRINGType of action taken.
flagged_dateDATEDate the sanction was flagged for review, if applicable.
verified_dateDATEDate the sanction was last primary-source verified.
sourceSTRINGSystem/process that sourced this record (e.g. OIG, SAM.gov).

Performance_Indicators 10 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
total_complaintsINTEGERTotal number of complaints recorded.
clinical_complaintsINTEGERNumber of clinical-quality complaints.
service_complaintsINTEGERNumber of service-related complaints.
benefits_complaintsINTEGERNumber of benefits-related complaints.
claim_complaintsINTEGERNumber of claims-related complaints.
access_issue_complaintsINTEGERNumber of access-to-care complaints.
report_dateDATEDate the performance indicators were reported.
verified_dateDATEDate the performance indicators were last primary-source verified.

App_Verifications 6 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
verification_typeSTRINGType of application verification performed.
explanationSTRINGFree-text explanation/notes for the verification.
verified_dateDATEDate the verification was completed.
sourceSTRINGSystem/process that sourced this record.

Professional_IDs 9 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
typeSTRINGType of professional identifier (e.g. UPIN, taxonomy ID).
numberSTRINGThe identifier value.
stateSTRINGState associated with the identifier, if applicable.
issue_dateDATEDate the identifier was issued.
expiration_dateDATEDate the identifier expires, if applicable.
sourceSTRINGSystem/process that sourced this record.
verified_dateDATEDate the professional identifier was last primary-source verified.

Languages 4 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
languageSTRINGLanguage spoken by the practitioner.
is_primaryBOOLEANWhether this is the practitioner's primary language.

Licensure_Actions 9 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
stateSTRINGState that took the licensure action.
action_typeSTRINGType of licensure/disciplinary action.
detailsSTRINGFree-text details of the action.
last_action_dateDATEDate of the most recent action.
report_dateDATEDate the action was reported by the primary source.
sourceSTRINGSystem/process that sourced this record.
verified_dateDATEDate the licensure action was last primary-source verified.

Disclosure_Questions 7 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
questionSTRINGDisclosure question text presented to the practitioner.
answerSTRINGPractitioner's answer to the disclosure question.
answer_flagBOOLEANWhether the answer was flagged for follow-up (e.g. a "Yes" to a disqualifying question).
disclosure_dateDATEDate the disclosure was recorded.
explanationSTRINGPractitioner-provided explanation for a flagged answer.

CDS 11 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
numberSTRINGControlled Dangerous Substances (CDS) registration number.
stateSTRINGState that issued the CDS registration.
provider_typeSTRINGProvider type classification for the registration.
expiration_dateDATECDS registration expiration date.
expire_dateDATESecondary/raw expiration date field from the source system.
verified_dateDATEDate the registration was last primary-source verified.
statusSTRINGCurrent status of the registration.
sourceSTRINGSystem/process that sourced this record.
urlSTRINGURL to the primary-source verification record.

CLIA_Certificates 4 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
certificate_numberSTRINGCLIA certificate number.
expiration_dateDATECLIA certificate expiration date.

CMS_Specialties 4 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
cms_type_codeSTRINGCMS specialty type code.
cms_type_nameSTRINGCMS specialty type name/description.

Medicaid 6 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
medicaid_numberSTRINGPractitioner's Medicaid provider number.
medicaid_stateSTRINGState the Medicaid number was issued in.
stateSTRINGState associated with this Medicaid record.
cds_numberSTRINGAssociated CDS number, if recorded on this Medicaid record.

Medicare 4 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
medicare_numberSTRINGPractitioner's Medicare provider number (PTAN).
medicare_stateSTRINGState the Medicare number was issued in.

Work_History_Gaps 6 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
gap_start_dateDATEStart date of the work history gap.
gap_end_dateDATEEnd date of the work history gap.
explanationSTRINGPractitioner-provided explanation for the gap.
verified_dateDATEDate the work history gap was last verified.

X_Ray_Licenses 4 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
license_numberSTRINGX-ray operator/technician license number.
expiration_dateDATEX-ray license expiration date.

Outreach 19 fields

FieldTypeDescription
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
entity_npiSTRINGPractitioner NPI; joins to Main_Workflow_Data.entity_npi.
entity_full_nameSTRINGPractitioner's full name.
outreach_idSTRINGUnique identifier of the outreach record.
outreach_typeSTRINGType of outreach (e.g. practitioner).
outreach_sent_by_emailSTRINGEmail of the internal user/system that initiated the outreach.
outreach_created_atDATEDate the outreach record was created.
credentialing_cycleSTRINGCredentialing cycle the outreach relates to.
outreach_reasonsSTRINGReason(s) the outreach was initiated (e.g. missing documents).
email_idSTRINGUnique identifier of the associated email.
email_directionSTRINGDirection of the email: INBOUND or OUTBOUND.
email_subjectSTRINGSubject line of the email.
email_bodySTRINGRaw body content of the email (may contain HTML).
email_sent_atDATEDate the email was sent.
email_sent_by_emailSTRINGEmail address of the sender.
email_to_addressesSTRINGRecipient (To) email address(es).
email_from_addressSTRINGSender (From) email address.
email_cc_addressesSTRINGCC email address(es).
email_bcc_addressesSTRINGBCC email address(es).

Activity_Timeline 7 fields

FieldTypeDescription
event_idSTRINGUnique identifier of the timeline event.
workflow_idSTRINGJoin key linking this row to Main_Workflow_Data.workflow_id.
created_atTIMESTAMPTimestamp the timeline event occurred.
created_by_emailSTRINGEmail of the user who triggered the event, if any.
previous_event_idSTRINGIdentifier of the timeline event immediately preceding this one.
credentialing_statusSTRINGCredentialing status/step name recorded by this event.
change_reasonSTRINGReason recorded for the status change, if any.