An example of provider credentialing as a governed process: agents do the 7 steps, and a person signs 2 gates before anything irreversible happens. Download it, import it into your workspace, and adapt it to your systems.
minctrl.process/v1 · hash 66089e1ebdd0…ed90
Credentialing is months of repetitive primary-source verification, and a negligent-credentialing miss is direct liability — every clinician is re-verified by every payer. Licenses, education and history are primary-source verified and payer enrollments submitted straight-through; the committee signs the privileging decision and every adverse finding.
Granting or denying clinical privileges is a peer-review decision with patient-safety and legal weight, so the credentialing committee or medical director signs off before a provider is approved or denied.
| Rule | What it requires |
|---|---|
| NCQA credentialing standards | Credentialing relies on primary-source verification (PSV) of license, board certification, education/training, DEA and work history, within NCQA's look-back and timeliness expectations. |
| Primary-source verification | Qualifications must be confirmed directly with the issuing source (e.g. state board, ABMS, NPDB) rather than from a copy the applicant provides. |
| NPDB / OIG-SAM sanctions checks | The National Practitioner Data Bank and OIG/SAM exclusion lists are checked so an excluded or sanctioned provider is not credentialed. |
| Credentialing committee / peer review | The approval to grant or deny privileges is a peer-review decision made by a credentialing committee or medical director, not clerical staff. |
A summary for orientation, not legal advice.
A minctrl.process/v1 document: the graph and the hash of the process it becomes.
Import into Minctrl opens this example in your workspace; one click stores it as your first version. Import JSON does the same with the file, and a file changed after download is refused.
Every connector starts in shadow: steps run, nothing leaves Minctrl until you configure a connector and switch it live.
Change signers, time limits and steps on the canvas. Each save is a new version; a running case stays on the version it started with.
The example models primary-source verification: license, board certification, education, DEA and work history are confirmed with the issuing source, and each verification is timestamped and logged with a tamper-evident audit hash. Whether your program meets NCQA standards depends on your policies, your sources and your own accreditation review. Minctrl holds no certification, and this is not legal advice.
The AI agent screens the NPDB and OIG/SAM exclusion lists as part of the file. A hit is escalated rather than auto-cleared, so an excluded or sanctioned provider cannot slip through to a privileges decision.
The credentialing committee or medical director. Granting or denying clinical privileges is a peer-review decision with patient-safety and legal weight, so it parks at a human sign-off gate; the AI assembles and verifies the file, a person makes the call, and the rationale is recorded.