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Provider status, location, and network participation update in real time, not on a quarterly refresh.
Provider Network & OperationsHealthOS: Provider Credentialing Software
HealthOS: Provider Credentialing Software
with Real-Time Directory Accuracy
HealthOS Provider delivers credentialing software and provider data management for IPAs, ACOs, and health systems. Onboarding, credentialing, eligibility, referrals, and reimbursement live in a single record, continuously updated by Aipass™ instead of relying on quarterly refreshes.
HITRUSTSOC 2 Type IICMSHL7 FHIR
DirectoryCredentialingReferralsContracts
Quality Score88.4
Credentialed3,455
Pending PSV27
Dr. Alvarez CardiologyCredentialing complete
ActiveNorthside Medical GroupDirectory listing verified
ActiveGroup NPI 10442License renewal due in 12 days
ReviewAIAipass™ re-verified 1,204 licenses overnight and surfaced 9 records that need a credentialing specialist.
Workspace Overview
What Is HealthOS Provider?
HealthOS Provider serves as the provider workspace within HealthOS, the operational backbone of Enterprise Healthcare Operating System (EHOS). As provider network management software, it centralizes credentialing, directory, referral, and contract data for IPAs, ACOs, and health systems into a single record. CAPS and Plan both read and write to this unified record, ensuring directory updates are reflected instantly without the need for exports. It meets CMS Interoperability Rule directory requirements without requiring a separate export process.
One Provider Record on the Shared Data Core
Every HealthOS workspace uses a single live record of the shared data core, connecting directory, credentialing, claims, eligibility, and quality data. This eliminates the need to reconcile separate systems.
Aipass™ Monitors Continuously
Aipass™, the intelligence layer running across HealthOS, performs license, sanction, and network adequacy checks in the background and flags exceptions for a credentialing specialist.
Platform Foundation
Provider Data Accuracy That Doesn't Depend on a Refresh Cycle
Provider data accuracy is a monitoring problem, not a refresh problem. HealthOS Provider is provider data management software that updates status, location, and network participation in the live record and logs every decision and change for audit.
Immutable Security & Audit
Decisions and changes are logged to support HITRUST and SOC 2 Type II obligations.
Provider Data Integrity Across Every Workspace
Directory and credentialing data connect to claims, eligibility, and quality data on the shared data core, so every workspace reads the same record.
Aipass™ Embedded Intelligence
Aipass™ runs license, sanction, and network adequacy checks in the background and flags exceptions for a credentialing specialist.
Inside Provider
Five Modules for Provider Network Management
Pick a module to see what your team actually touches inside it.
Credentialing & Enrollment
Medical credentialing software for onboarding and recredentialing: primary source verification, license monitoring, recredentialing, and delegated credentialing for IPAs and ACOs.
Primary Source VerificationLicense MonitoringRecredentialingDelegated Credentialing
Pending PSV27
Attestations Due18
Avg Cycle Time9.2d
Dr. AlvarezCredentialing complete
ActiveDr. ChenLicense verification in progress
In ProgressGroup NPI 10442Sanction check flagged
ReviewDirectory & Network
A live provider directory and network view. Status, location, and network participation update in real time.
Live DirectoryNetwork AdequacyMulti-Location SupportPublic Directory Feed
Listed Providers3,455
Adequacy Gaps1
Updates This Week84
Northside Medical GroupListing verified
ActiveCardiology NetworkAdequacy gap flagged
ReviewDirectory FeedPublished to CMS portal
ProcessedReferral Management
Referrals route to in-network providers with open capacity by default, reducing accidental out-of-network leakage.
In-Network RoutingSpecialist CapacityReferral TrackingPA Linkage
Referrals MTD1,880
In-Network Rate96.4%
Avg Wait4.1d
Referral REF-2291Routed to in-network specialist
CompleteReferral REF-2288Capacity limited, alternate suggested
PendingReferral REF-2270Out-of-network flagged
ReviewReimbursement & Contracting
Fee schedules, contract terms, and DOFR arrangements are visible in one place, so payment disputes start from shared facts.
Fee SchedulesContract TermsDOFR VisibilityDispute Workflow
Active Contracts1,842
Expiring (90d)28
Open Disputes4
Contract CN-2291Renewal needed
ReviewFee Schedule UpdatePublished
ProcessedDispute DS-118Resolved
ClosedQuality & Performance
Quality metrics are tracked continuously after a provider goes live.
Quality ScorecardsClean Claim RatePeer BenchmarkingShared With Plan
Avg Quality Score88.4
Top Quartile Providers612
Flagged for Review9
Dr. AlvarezQuality score 94.2
Top QuartileGroup NPI 10442Clean claim rate declining
ReviewQuarterly ScorecardsPublished
ProcessedHow Work Moves
From Application to Active In-Network Provider
A provider moves from application to active in-network provider in five steps, and the work does not stop at go-live.
- Application
The provider or group submits credentials through the portal or a delegated feed.
- Primary source verification
Aipass™ checks licenses, certifications and exclusion lists and flags items for review.
- Contracting
Fee schedules and contract terms are finalized and linked to the provider record.
- Directory publish
The provider goes live once credentialing and contracting are complete.
- Ongoing monitoring
Sanctions, license renewals, and quality metrics are tracked continuously.
The Intelligence Layer, Inside Provider
Keeping a Network Current Is a Monitoring Problem. Aipass™ Treats It Like One.
Aipass™ is the AI engine inside HealthOS. In the Provider workspace it runs continuous primary source verification, sanction and exclusion checks, and network adequacy checks, and sends only the exceptions to a credentialing specialist.
Learn how Aipass™ monitors provider dataLive decision intelligence● Active
Group NPI 10442Needs Review01 / Review
Analysis completeState license verified · Board certification current · Primary source check returned an updated sanction record requiring human review.
RecommendationRoute to credentialing specialist with the source record and comparison history attached.
Confidence 97%
Why HealthOS Provider?
The Numbers Behind the Console.
What IPAs, ACOs, and health systems typically see after moving network operations onto Provider.
4.4/5Quality rating
32%Increase in Care Gap Closure
22%Fewer Readmissions
Why Provider
What Changes When Network Operations Run on Provider.
The difference shows up the moment someone actually needs the directory to be right.
The Old Way
- Directory listings are exported quarterly and are already stale by the time anyone uses them.
- Credentialing means chasing documents by phone and email, one provider at a time.
- Referrals leak out of network because nobody can see live specialist capacity.
- Reimbursement disputes start from two different spreadsheets of contract terms.
On Provider
- Directory updates reflect across HealthOS the moment a provider's status changes.
- Aipass™ runs primary source verification automatically, flagging only what needs review.
- Referrals route to in-network providers with visible open capacity by default.
- Fee schedules and contract terms are visible in one place, shared by every workspace.
Security & Compliance
Built to the Standards Your Compliance Team Already Holds You To.
Role-based access control, encryption in transit and at rest, and a complete audit log across every module — the same baseline for every HealthOS workspace.
HITRUSTSOC 2 Type IINCQAHL7 FHIR R4CMS Interoperability RuleEDI 837 · 835 · 270 · 271
FAQ
Frequently Asked Questions
Yes. HealthOS Provider supports delegated credentialing: IPAs and ACOs run their own credentialing workflows and stay visible to the health plans they contract with.
Directory data lives in the same live record used across HealthOS, so status and network changes appear immediately rather than through a batch export.
It can. HealthOS Provider runs credentialing and directory and network management natively, so a team can consolidate a separate credentialing vendor and directory tool.
HealthOS Provider aligns with HITRUST, SOC 2 Type II and CMS requirements and keeps a complete audit log across modules.
Provider credentialing software collects a provider's credentials, verifies them against primary sources, and tracks licenses and recredentialing. HealthOS Provider does this on the same record as its directory and contracts, and Aipass™ re-checks licenses and sanctions in the background.
Provider data management is keeping provider records, such as status, location and network participation, accurate and consistent across every system that uses them. In HealthOS Provider they live on one record, so the directory, claims, and eligibility read the same data.
Aipass™ checks licenses, certifications, and exclusion lists during verification and continuously monitors sanctions in the background. When something changes, it flags the record for a credentialing specialist with the source record attached.
Yes. Aipass™ runs network adequacy checks in the background alongside license and sanction checks.
One Console, One Suite
Six Workspaces. One Record.
Every HealthOS workspace reads and writes to the same core. Start with Provider, connect the rest whenever your team is ready.
Get Started
See HealthOS Provider in the Context of Your Operations
Bring your line of business and your hardest workflow — we’ll show you how it runs on one intelligent platform.
