Healthcare Data Quality

The Eligibility Data Other Vendors Can’t Match

Every check ProviderTrust runs, whether it’s screening an employee for exclusions, verifying a vendor’s standing, or confirming a provider’s license, relies on the same core capability: data enrichment. It’s the strategy that turns an incomplete primary source record into a verified, exact-match result, and it’s why our data holds up under scrutiny in ways other vendors’ data doesn’t.

Our Data Quality by the Numbers

ProviderTrust’s enhanced data is built on more than 50 federal and state primary sources and more than 15 years of primary source data infrastructure.

of all exclusions that exist today are enriched with our data’s unique identifiers

of exclusions found only with our enhanced primary source data

license and credential verifications performed annually

Overview

Our data enrichment strategy

Most vendors return whatever a primary source hands them. Exclusion lists, licensing boards, and registries are all disjointed by nature, and a discrepancy between one record and another becomes the client’s problem to solve, whether the person in question is an employee, a vendor, or a provider.

ProviderTrust closes that gap with data enrichment: we connect unique identifiers across more than 50 federal and state primary sources to build a single, verified profile for every individual and entity we monitor, rather than a name-only match from one source. Every newly enriched record is reviewed by  ProviderTrust’s data experts before it’s added, and escalated for further research when they disagree, at no extra cost to clients.

This is the same strategy behind every ProviderTrust product, applied to whichever population you’re checking.

How We Help

Built into everything we monitor, not just one dataset

Compliance Data

Exclusions and sanctions

Enrichment applies the same way whether we’re screening one new hire or an entire provider network. Last year alone, ProviderTrust identified 7,222 exclusions, and 1,870 of them, about 26%, were found only through our enriched dataset (Year in Review, 2025). That pattern holds at scale, too: in a new joint report with Defacto Health analyzing 124 payer directories, 27% of the excluded providers found across those networks surfaced only through enhanced primary source verification and enrichment, meaning a standard, point-in-time check would have missed them entirely.

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Credentialing Data

Licenses and certifications, verified in real time

Our credentialing data is powered primarily by DynamicNPI, ProviderTrust’s verified provider data source. Today, DynamicNPI includes more than 4 million verified provider profiles and more than 11 million licenses and credentials, returning results in about half a second. Across all of ProviderTrust, we perform more than 210 million license verifications annually, covering more than 6,667 license and credential types, with more than 302 added in 2025 alone. 

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Workforce Data

The same rigor for your entire population

Employees and vendors get the same enrichment treatment as providers, not a lighter version of it. Whether you’re checking a new hire at the point of pre-employment, monitoring a vendor’s owners and subcontractors, or maintaining ongoing eligibility for your whole workforce, the underlying verification is identical: unique identifiers matched against primary sources, reviewed by our data oversight team, and delivered as an exact match, not a “potential match” for your team to resolve.

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Verified provider data in under half a second with DynamicNPI®

ProviderTrust’s real-time source of verified, up-to-date provider information, DynamicNPI is the healthcare industry’s most comprehensive source of verified provider data, connecting disparate primary source information directly to NPI numbers and delivering a fully verified provider profile into your workflow of choice in 0.5 seconds.

  • 360-degree provider eligibility
  • Data for all departments
  • Seamless integration
  • Ongoing monitoring
  • NCQA-certified automation
  • Expiration tracking

Better decisions start with
better data.

WHY PROVIDERTRUST

What makes ProviderTrust’s data more accurate

Newer, well-funded competitors can build software quickly. What they can’t do is manufacture 15 years of primary source relationships, enriched records, and edge cases already resolved. Independent research backs up why that depth matters: a 2026 Healthcare Dive and ProviderTrust survey found that while 92% of healthcare executives have actively sought to consolidate their eligibility data, only 23% are extremely confident in the quality of what they have today. A related ProviderTrust survey of payer executives found similar gaps between perceived and actual data quality across provider networks.

ProviderTrust’s approach to closing that gap includes:

  • More than 50 federal and state primary sources, monitored continuously rather than on a fixed cycle
  • A dedicated data oversight team that resolves flagged matches before they ever reach a client, at no extra cost
  • HITRUST CSF Certified (via the r2 assessment), NCQA CVO Certified, and SOC 2 Type II compliant
  • Data delivered via API or the Monitoring and Verification Platform, wherever your team already works

FREQUENTLY ASKED QUESTIONS

FAQs about healthcare data quality

Data enrichment is ProviderTrust’s process for linking unique identifiers from multiple primary sources to build a single verified profile for each individual or entity, rather than relying on a single source’s incomplete record.

No. ProviderTrust applies the same enrichment strategy across employees, vendors, and providers. The underlying verification, unique identifiers matched against primary sources and reviewed by our data oversight team, doesn’t change based on who’s being checked.

More than 50 federal and state primary sources, including exclusion and sanction lists, licensing boards, the DEA, state-controlled substance registries, and board certification bodies.

Every flagged match is reviewed by two of ProviderTrust’s data experts and escalated for further research when they disagree, at no additional cost to clients.

Let’s talk

See how ProviderTrust can work for your organization.