Who it’s for / Payers & health plans
A roster arrives as a claim. You are graded on it as a fact.
Bip does not sell to health plans. It sits with the groups and systems that send you rosters — the only place a roster’s accuracy is decided.
| Change | Provider · field | Source | Confirmed |
|---|---|---|---|
| Add | Okafor, Dana T., MDAZ medical license | AZ Medical Board | 08 / 28 |
| Add | Okafor, Dana T., MDIdentity | Government ID | 08 / 26 |
| Change | Reyes, J. Carlos, MDMalpractice COI | Provider-supplied | 09 / 01 |
| Change | Okonkwo, Ada N., NPPractice location | Provider attestation | 08 / 19 |
| Term | Whitfield, Marcus A., DONetwork status | Group attestation | 03 / 14 |
The roster you already receive, diffed against last cycle — every add, change and term carrying the source it came from and the date it was confirmed.
The problem
You inherit a file you did not build.
Every row is a name, an NPI and a set of dates that were true whenever somebody last typed them.
A roster tells you what a group believes. It does not say when a field was last confirmed, which source confirmed it, or whether anyone established that the person behind the NPI is who the row says. Normalization fixes the format. It cannot supply provenance the file never carried.
The thirty-day update window and the annual attestation land on you. The data behind them is maintained somewhere you do not operate.
Average days a directory inaccuracy persists, for roughly 40% of inaccuracies. The federal requirement is an update within 90 days.
Health plan contracts a typical practice maintains, each on its own platform, format and schedule.
Other people’s research, attributed so it can be argued with. The update and attestation requirements are CMS-4208-F2 — check the rule itself.
What a row stands on
The NPI is an identifier, not an authenticator.
It was issued to a record, and a record can be borrowed, inherited or stolen.
Fraudulent nursing diplomas traced to a handful of schools. Every clinician holding one sat a real exam, held a real license and passed credentialing. Verification chains inherit trust, so a false foundation verifies cleanly — and then arrives on a roster looking like every row around it.
No roster file has a column for this, which is why no ingestion logic catches it.
When the group is on Bip
Provenance travels with the file.
Same roster, same cadence, same format — and every field able to say where it came from and when.
- Bound to a person
- Every credential hangs off an identity authenticated with a government ID, not off a name and a number.
- Sourced, and dated
- Licenses are verified against the issuing state board; exclusions screened monthly against OIG LEIE, the run recorded whether or not anything matches. Everything else is labeled provider-supplied.
- Attested by the provider
- The person with the best information maintains the record and attests to it, with a timestamp.
- Diffed against your last file
- Adds, changes and terms come off the same record the group credentials from, compared against what you were sent last cycle.
Questions we get
Where Bip sits, plainly.
If Bip does not sell to plans, what do we get from it?
What does Bip do about delegated credentialing?
Ask a group for one roster row’s history.
Where each field came from, when it was last confirmed, and by whom. That is the file worth ingesting.