Glossary
Shared language for a workflow that usually lives in tribal knowledge.
Roster operations sit between credentialing and billing, but most organizations don't have shared vocabulary for what happens in between. These definitions help.
Why it matters
These definitions help teams talk about the same problem the same way.
Terms
B
- Billing readiness
- The point at which a provider can actually submit claims to a payer and receive reimbursement.
C
- Competitive listing
- When multiple employers' roster updates conflict for the same provider in a payer directory.
- Credentialing
- The process of verifying a provider's qualifications, licenses, and background before they can participate in a payer's network.
D
- Directory accuracy
- Whether provider details in a payer's public directory match real-world provider information.
- Directory lag
- The delay between submitting a roster update to a payer and the update appearing in the payer's directory or systems.
G
- Ghost directory
- A payer directory listing that shows incorrect, outdated, or phantom provider information.
P
- Payer confirmation
- The moment a payer acknowledges that a roster update was received, processed, and loaded.
- Post-submission visibility
- The ability to track what happens after a roster update is sent to a payer.
- Provider enrollment
- The process of registering a credentialed provider with a specific payer so they can submit claims and receive reimbursement.
R
- Roster reconciliation
- Comparing submitted provider data against what payer directories actually show, field by field.
- Roster update
- A submission to a payer that adds, removes, or changes provider information tied to your organization.
T
- Taxonomy code
- A standardized classification code for a provider's specialty used in payer directories.
- Time to bill
- The elapsed time from provider submission to a payer until they can actually bill for services.
Missing a term?
This glossary grows with the conversation.
If there's a term your team uses that isn't here, let us know. We'll add it.