# DenQAI: payer network map

File-specific companion · 2026-09-10

## Purpose

Which contract and network route actually applies to this payer product?

**Who:** Credentialing or contract lead and qualified reviewer

**Records:** Executed contracts; leasing notices; fee effective dates; credentialing records; authorized remittance evidence.

## Complete the file

1. Identify carrier, product, network_name, and contract_source for each coded relationship.
2. Record direct_leased_or_shared, controlling agreement locator, fee date, notice status, and credentialing date.
3. Validate a representative remittance in the authorized system and document limitations and next_action.

## Definitions

- **Network source:** The agreement or arrangement providing access to the relevant network.
- **EOB:** Explanation of benefits; a payment explanation to reconcile with the applicable relationship.
- **Fee schedule effective date:** Date on which the identified schedule applies under reviewed terms.

## Fictional example

Fictional example: Product A lists a leased network; the executed agreement locator is blank, so representative_eob_validated remains No pending review.

## Review and next action

Resolve the missing contract or network-path evidence before using a fee or participation assumption.

A payer brand or one remittance does not establish all products, locations, providers, or future participation rights.

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

## AI coach prompt

Help me use DenQAI’s payer network map. My question is: Which contract and network route actually applies to this payer product? Explain these terms in plain language: Network source, EOB, Fee schedule effective date. Ask one question at a time about the required records: Executed contracts; leasing notices; fee effective dates; credentialing records; authorized remittance 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: A payer brand or one remittance does not establish all products, locations, providers, or future participation rights. End with the missing evidence and this next step: Resolve the missing contract or network-path evidence before using a fee or participation assumption.

## AI review prompt

Review my permitted fictional or aggregate draft of DenQAI’s payer network map 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: Identify carrier, product, network_name, and contract_source for each coded relationship. Record direct_leased_or_shared, controlling agreement locator, fee date, notice status, and credentialing date. Validate a representative remittance in the authorized system and document limitations and next_action. Separate facts from assumptions and missing records. Do not supply unsupported numbers or make a professional decision for me. Apply this limitation: A payer brand or one remittance does not establish all products, locations, providers, or future participation rights. Return corrections, questions for the responsible reviewer, and the next action.