How To: Review Provider Details in the Population Page

Summary

This article provides instructions on how to locate and review a specific provider record within the Population tab. It details each section of the Provider Profile, including Overview & Alerts, Profile Data, Credentials, and Sanctions. This article also explains how to interpret color-coded statuses and access comprehensive alert and credential information.

Watch this 4-minute video on how to review provider details in the population tab

How to Access Provider Details

Use the search field to enter a Name, NPI, or External ID, then select the desired entity. Press Enter or select Filter to return your searched criteria. Selecting a single row will open the Population Member page, which contains four primary tabs: Overview & Alerts, Profile, Credentials, and Sanctions.

Overview & Alerts

The Overview & Alerts tab provides a high-level snapshot of monitored activity and potential risks.

1. The Overview displays all Monitored Products with color-coded result statuses:

   • Green: No issues identified

   • Yellow: Insufficient information

   • Red: Issues identified

2. The Alert History table includes:

   • Alert Type

   • Source

   • Result

   • Alert Creation Date

   • Review Status

3. The right-side panel displays key provider information, including:

   • Provider Information, including: Date of Birth, SSN, and Address(es)

   • Network Information, determined during implementation

   • Additional Information, including: External ID, Specialty, TIN, Provider Type (Individual or Organization), Taxonomy, and Monitored Subject ID

Selecting a red Product or Alert Type will automatically navigate you to the Alerts tab for deeper insight.

Profile

The Profile tab consolidates both Client-Supplied Data and NPPES Data for easy comparison.

1. Client-Supplied Data Includes:
   • Name, NPI, TIN
   • Provider Type (Individual or Organization)
   • Start Date
   • SSN and Date of Birth
   • Addresses
   • External ID
   • Monitored Subject ID
2. NPPES Data Includes:
   • Name, NPI, TIN
   • Provider Type
   • Start Date
   • SSN and Date of Birth
   • Addresses
   • Licenses
   • External ID
   • Monitored Subject ID

3. The Hierarchy Table within this tab provides additional organizational context when business units or networks are assigned.

Credentials

The Credentials tab offers a visual, at-a-glance view of Credential Expiration and Credential Result Status.

Credential Expiration Status Chart

*Note: Most commonly a license will be deleted by a client-supplied file; however, there are some instances where a client may request a license to be removed via an escalation ticket to the ProviderTrust support team.

Credential Details

Users can click any license or board certification row to view full credential details. These details will include the following:

1. All available Primary Source information
2. Board Actions 
3. Alert History
4. Primary Source Screenshot(s)

Sanctions

• Federal and State Exclusions tables display results in a color-coded status system:

  • Green: No issues

  • Yellow: Insufficient information

  • Red: Issues identified

Only states with specific exclusions will be listed individually; otherwise, "All Other States" will be indicated.

• Other Sources table expands compliance coverage and includes results and monitoring frequency for:

  • CMS Preclusion List

  • NPI Validation

  • OFAC

  • Opt Out

  • SSDMF

Match Result Details

When a Match Result is selected, full sanction details appear in the right-side dialog box. Detailed information is only available for Red results; green and yellow statuses do not display additional details