# DenQAI: payer credentialing critical path

File-specific companion · 2026-09-10

## Purpose

Which of the eight credentialing steps lacks the evidence needed for this exact relationship?

**Who:** Credentialing owner with provider and billing support

**Records:** Current identifiers; attestation; executed terms; effective-date confirmation; claim, EFT/ERA, and first-payment evidence.

## Complete the file

1. Use the same payer, provider, entity, location, product, and network codes across all eight rows.
2. Record each step status and supporting_document_locator; leave unconfirmed dates unresolved.
3. Assign the next_action and recheck_trigger to an owner_role, then recheck downstream steps after any identity change.

## Definitions

- **Network path:** The documented direct or leased route connecting the provider to the product.
- **Confirmed effective date:** Date supported by the applicable relationship record, not an application date.
- **Supporting document locator:** A code or location pointing to evidence kept in an authorized system.

## Fictional example

Fictional example: Provider 1 / Entity 1 / Location 1 / Product A1: profile complete, contract still requested; leave confirmed_effective_date blank and assign contract follow-up.

## Review and next action

Request the missing controlling record for the earliest incomplete step.

The CSV tracks evidence; NPI, attestation, a directory listing, or one paid claim alone does not establish every participation requirement.

[Related DenQAI guide](https://denqai.com/insurance)

## AI coach prompt

Help me use DenQAI’s payer credentialing critical path. My question is: Which of the eight credentialing steps lacks the evidence needed for this exact relationship? Explain these terms in plain language: Network path, Confirmed effective date, Supporting document locator. Ask one question at a time about the required records: Current identifiers; attestation; executed terms; effective-date confirmation; claim, EFT/ERA, and first-payment evidence. Walk through the supplied fictional example before asking me for inputs. Treat every missing value as unknown, not zero. Do not invent source records, contract terms, legal conclusions, or clinical facts. Use only permitted fictional or aggregate, non-identifying information. Follow this boundary: The CSV tracks evidence; NPI, attestation, a directory listing, or one paid claim alone does not establish every participation requirement. End with the missing evidence and this next step: Request the missing controlling record for the earliest incomplete step.

## AI review prompt

Review my permitted fictional or aggregate draft of DenQAI’s payer credentialing critical path against the file instructions. Check each required field and period, units, evidence locator, assumptions, arithmetic where formulas are actually supplied, and unresolved contradictions. Check the sequence: Use the same payer, provider, entity, location, product, and network codes across all eight rows. Record each step status and supporting_document_locator; leave unconfirmed dates unresolved. Assign the next_action and recheck_trigger to an owner_role, then recheck downstream steps after any identity change. Separate facts from assumptions and missing records. Do not supply unsupported numbers or make a professional decision for me. Apply this limitation: The CSV tracks evidence; NPI, attestation, a directory listing, or one paid claim alone does not establish every participation requirement. Return corrections, questions for the responsible reviewer, and the next action.