ProviderTrust
ProviderTrust is a Nashville-based healthcare compliance technology company founded in 2010 that provides automated exclusion monitoring, credential verification, and vendor compliance solutions to 1,000+ US healthcare payers and providers via API-integrated subscriptions.
- Company typePrivate
- Founded2010
- HeadquartersNashville, United States
- Headcount101–250
- GTM typeB2B
- OfferingSoftware
What ProviderTrust does
ProviderTrust is a Nashville-based healthcare compliance technology company founded in 2010 that delivers automated credential verification, exclusion monitoring, and vendor compliance solutions primarily to US healthcare payers and providers. The company's core platform continuously screens employees, contractors, vendors, and provider networks against federal exclusion databases (HHS-OIG LEIE, GSA SAM.gov, CMS Preclusion List, OFAC SDN) and all 50 state Medicaid exclusion/sanction lists, with NCQA CVO certification across six primary source verification areas (DEA Registration, Medical Board Sanctions, Medicare/Medicaid Sanctions, Ongoing Monitoring of Sanctions, Board Certification Status, Licensure Verification). The proprietary data enrichment engine adds unique identifiers to primary source data, delivering exact-match results that the company reports catch 46-51% of exclusions missed by other vendors. DynamicNPI®, launched in 2024, provides real-time verified provider data via API in under 0.5 seconds, covering 4M+ provider profiles and enabling automated credentialing decisions.
The product portfolio is organized into three payer-facing modules (Provider Credentialing, Provider Network Compliance, Provider Network Operations) and three provider-facing solutions (Exclusion List Monitoring, License and Credential Verification, Comprehensive Vendor Compliance). All offerings are delivered through bi-directional API or SFTP integrations into client HRIS platforms (ADP, Oracle, Workday, Ultimate Software, Talentwise), enabling compliance monitoring to be embedded directly into existing client workflows rather than operated as a standalone portal. ProviderTrust holds HITRUST CSF and SOC 2 Type II certifications and is the first healthcare eligibility data provider to establish a formal AI governance body (AI Integrity Council, March 2026) following the NIST AI Risk Management Framework.
The business model is subscription-based recurring revenue with enterprise contracts, supplemented by per-vendor participation fees ($55 annually per vendor in the Comprehensive Vendor Compliance program) and per-verification or per-API-call pricing components within enterprise agreements. Distribution combines direct enterprise field sales targeting large payers and providers with a formal Partner Program (Integration Partners and Referral Partners) and an API-first go-to-market that leverages embedded integrations into HRIS ecosystems. The company monitors 14M+ people and entities, performs 180M+ license verifications annually, serves 1,000+ customers, and employs 130+ team members across its Nashville headquarters.
ProviderTrust firmographics
Firmographics- Name
- ProviderTrust
- Legal name
- ProviderTrust, Inc.
- Website
- https://providertrust.com
- Company type
- Private
- Founded year
- 2010
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- ProviderTrust is a Nashville-based healthcare compliance technology company founded in 2010 that provides automated exclusion monitoring, credential verification, and vendor compliance solutions to 1,000+ US healthcare payers and providers via API-integrated subscriptions.
- Ownership category
- akta.pro rank
ProviderTrust industry classification
Industry- Product category
- Healthcare Compliance Software
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)
- SIC
- Services-Health Services (8000), Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- Provider Network, Credentialing & Contracting Support (BPAAAFAI)
- akta.pro secondary industry
- Eligibility & Benefits Verification (HLACACAD)
Keywords
Where ProviderTrust is headquartered
LocationHeadquarters
- HQ city
- Nashville
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
ProviderTrust business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Operations, Marketing or Sales
Revenue model
- Subscription-Based Compliance Monitoring: ProviderTrust operates on a recurring subscription model, providing automated exclusion list monitoring, license and credential verification, and continuous compliance monitoring on an ongoing basis. Clients pay for access to the platform and its monitoring services, likely on an annual contract basis with per-member or per-verification pricing components. The company's focus on 'saving time and costs' for clients and 'reducing credentialing turnaround times by 97%' suggests a value-based recurring revenue structure.
- Vendor Compliance Management: Comprehensive vendor compliance program that includes annual vendor data collection and ongoing monitoring. Each vendor pays an annual fee of $55 to offset the cost of monitoring. This represents both a B2B2C revenue stream where the healthcare organization pays for platform access and a secondary per-vendor fee.
- API / Data Integration Services: Revenue generated through API-first integrations connecting ProviderTrust's verified data platform into client systems (HRIS, ERP, provider network management). Delivered via bi-directional API or SFTP integration, likely with per-API-call or per-verification pricing within enterprise contracts.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Comprehensive Vendor Compliance - Vendor Participation Fee |
Go-to-market motion3 records
Distribution channels4 records
Marketing channels9 records
ProviderTrust product offering
Product offeringCore offering
ProviderTrust provides automated healthcare compliance software that screens providers, vendors, and network participants against federal and state exclusion lists and verifies professional licenses and credentials. Its platform supports continuous monitoring, primary-source verification, and network and vendor compliance workflows for healthcare payers, providers, and related organizations.
Product overview
ProviderTrust offers a platform of integrated compliance monitoring and credential verification solutions for healthcare payers and providers. The core portfolio includes Exclusion List Monitoring, License and Credential Verification, and Comprehensive Vendor Compliance as foundational services. DynamicNPI serves as the real-time verified data layer, connecting primary source information to NPI numbers. The Impact Compliance Program provides a standards framework. For payers, three modules address credentialing, network compliance, and network operations. All solutions share ProviderTrust's enhanced primary source data methodology, bi-directional API/SFTP delivery, and NCQA/HITRUST certifications.
Differentiator
Problem solved
Functional benefit
Brands
- DynamicNPI®: Real-time verified provider data source connecting disparate primary source information directly to NPI numbers. Delivers fully verified provider profile in under half a second.
- Impact Compliance™
Products and services
- Exclusion List Monitoring Automated SaaS solution that continuously screens individuals and entities against federal and state exclusion and sanction registries to help healthcare payers and providers stay compliant.
- License and Credential Verification Automated primary-source license and credential verification service that validates professional licenses, certifications, and credentials for healthcare providers.
- Comprehensive Vendor Compliance Compliance offering that screens and monitors vendors and third parties against exclusion lists and credentialing requirements for healthcare organizations.
- DynamicNPI Provider data management product focused on National Provider Identifier (NPI) data accuracy, validation, and ongoing maintenance for payer provider directories and network operations.
- Provider Credentialing for Payers Credentialing solution tailored for payer organizations to onboard, credential, and monitor network providers as part of payer network management.
- Provider Network Compliance Network compliance offering that ensures healthcare payer and provider networks meet regulatory and contractual compliance requirements through continuous monitoring and reporting.
- Provider Network Operations Operational solution supporting provider network data management and operational workflows for payers and providers, including directory maintenance and network data integrity.
Quantifiable outcome
- 46-51% of all exclusions found by ProviderTrust are likely missed by other vendors or systems, representing a significant data quality advantage.
- +4 more outcomes
Companies that use ProviderTrust
Customer profileNamed customers10 records
Segments5 records
Ideal customer profiles2 records
ProviderTrust technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration4 records
AI capability3 records
Feature6 records
ProviderTrust partnerships and signals
Strategic signalPartnerships
Three partnerships are on record, tiered core.
- J.D. Palatine (JDP)coreStrategic partnership to create a unified pre-hire screening and continuous eligibility monitoring workflow for the healthcare industry. The integration combines ProviderTrust's automated exclusion list checks and license verification with JDP's background screening capabilities, eliminating fragmented hiring processes, reducing time-to-hire, and maintaining regulatory compliance. The partnership addresses healthcare labor shortages by consolidating technology, reducing administrative burden, and enabling health systems to secure qualified caregivers faster.
- Madaket HealthcoreStrategic partnership to enhance provider data accuracy across healthcare. The partnership aims to improve provider data management and reduce administrative burden by integrating ProviderTrust's verified primary source data with Madaket Health's provider data management solutions.
- NtractscorePartnership to proactively address vendor risk in healthcare organizations. Ntracts contract management solutions integrate with ProviderTrust's vendor compliance monitoring to ensure vendors meet eligibility requirements as part of the contracting workflow.
Scale indicators17 records
Recent moves6 records
Expansion highlights6 records
ProviderTrust competitors and assessment
Company assessmentOthers
- SkillSurvey: SkillSurvey provides credentialing and reference verification solutions for healthcare employers. It is adjacent to ProviderTrust's license and credential verification use cases, particularly for HR teams, but does not specialize in continuous exclusion monitoring or payer network operations.
Direct peers
- Verifiable: Verifiable offers API-based credentialing, license verification, and exclusion monitoring for digital health companies and payers. Its product focuses on real-time provider verification workflows comparable to ProviderTrust's DynamicNPI, targeting similar buyer personas in digital health and payer network operations.
- PreCheck (backgrounds.com): PreCheck provides background screening, exclusion monitoring, and credential verification tailored to healthcare employers. It addresses the same workforce-compliance and exclusion-screening use cases as ProviderTrust's provider-side products, with a longer history in healthcare HR screening.
- symplr: symplr is a healthcare workforce and credentialing platform offering provider credentialing, exclusion screening, and compliance workflows for payers and providers. It is the most direct scaled competitor to ProviderTrust, with overlapping NCQA-certified credentialing and exclusion monitoring capabilities, though symplr operates as a broader suite spanning vendor management, quality, and workforce.
- CertifyOS: CertifyOS is a provider data and credentialing platform serving payers and digital health companies, automating primary source verification, network management, and directory accuracy. It competes most directly with ProviderTrust's payer-credentialing and network-operations modules.
- Medallion: Medallion provides API-first provider credentialing, licensure, and compliance automation for digital health and payer organizations. It overlaps directly with ProviderTrust's DynamicNPI and payer-credentialing modules, targeting the same primary-source-verification problem with an analogous API-first architecture.
Broad incumbents
- HireRight: HireRight is a global background screening provider with healthcare-specific exclusion monitoring and credential verification offerings. It overlaps with ProviderTrust's HR-side and exclusion monitoring capabilities but serves a much broader employer base across multiple industries.
- CAQH (Council for Affordable Quality Healthcare): CAQH operates the CAQH ProView provider data platform and related credentialing and directory infrastructure used by a large share of US payers and providers. It is a broad incumbent in primary source verification and provider data, overlapping with ProviderTrust's payer credentialing and network operations products but operating as a nonprofit industry utility.
- LexisNexis Risk Solutions (Healthcare): LexisNexis Risk Solutions provides large-scale data and analytics including healthcare provider data, exclusion screening, and credentialing intelligence. It is a broad incumbent with deep datasets relevant to ProviderTrust's core market, though it competes across many verticals rather than specializing in healthcare compliance.
- Sterling: Sterling provides background screening, identity verification, and credentialing services with healthcare industry exposure. It competes at the workforce screening layer similar to PreCheck and the HR-side of ProviderTrust's product set, though with a broader non-healthcare focus.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
ProviderTrust social profiles
Digital presenceProviderTrust compliance and trust
Trust signalCompliance3 records
ProviderTrust financial estimates
Financial estimateRevenue estimate
Valuation estimate
ProviderTrust leadership team
Management profileNumber of profiles
Profiles9 records
ProviderTrust funding detail
Funding detailFunding overview
Funding rounds4 records
Investors5 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ProviderTrust M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about ProviderTrust
What does ProviderTrust do?
ProviderTrust provides automated healthcare compliance software that screens providers, vendors, and network participants against federal and state exclusion lists and verifies professional licenses and credentials. Its platform supports continuous monitoring, primary-source verification, and network and vendor compliance workflows for healthcare payers, providers, and related organizations.
Is ProviderTrust a public or private company?
ProviderTrust is a private company. It is classified as private equity controlled and is currently operating.
When was ProviderTrust founded?
ProviderTrust was founded in 2010. It employs 101 to 250 people.
Where is ProviderTrust based?
ProviderTrust is headquartered in Nashville, United States, in the North America region.
How does ProviderTrust make money?
Three revenue lines are on record. Subscription-Based Compliance Monitoring is the primary driver. The others are vendor Compliance Management and API / Data Integration Services.
Who are ProviderTrust's main competitors?
SkillSurvey is listed as an others. Direct peers are Verifiable, PreCheck (backgrounds.com), symplr, CertifyOS and Medallion. Broad incumbents are HireRight, CAQH (Council for Affordable Quality Healthcare), LexisNexis Risk Solutions (Healthcare) and Sterling.
Does ProviderTrust have an API?
Yes. ProviderTrust offers a bi-directional API enabling real-time verification and continuous monitoring across exclusions, licenses, credentials, and provider data. The API integrates seamlessly into existing workflows and applications (HRIS, ERP, provider network management systems) to improve efficiency, reduce risk, and deliver monitoring insights and immediate verification results. API statistics cited: 75m+ records processed, supporting 12m+ entities. Bi-directional SFTP integrations are also available for optimal HRIS workflows. Developer documentation is at devdocs.providertrust.com/docs/getting-started.
What industry is ProviderTrust in?
ProviderTrust's product category is Healthcare Compliance Software. Its primary akta.pro industry code is BPAAAFAI, Provider Network, Credentialing & Contracting Support, with a secondary code of HLACACAD, Eligibility & Benefits Verification. Its NAICS code is 518 and its SIC code is 8000.