Back to search

provider accepting patients

prvdr_accpt_pt_ind
provider·Updated Jun 12, 2026

Definition

ISO-11179 Definition

A boolean indicator identifying whether a healthcare provider is currently accepting new patients for their practice, used in provider directory systems and network adequacy measurement. Provider acceptance status directly impacts member access to care — a network with technically sufficient provider counts but high rates of closed panels may fail practical access standards. CMS requires Medicare Advantage plans to maintain accurate accepting patients status in provider directories and to update directory information within 30 days of a status change.

Inaccurate accepting patients information is a leading cause of CMS audit findings and member complaints. Healthcare data teams build automated provider directory validation workflows that verify accepting patients status through provider attestation processes, flag outdated attestations for follow-up, and maintain audit trails of status changes for CMS compliance documentation.

Standard Abbreviation

prvdr_accpt_pt_ind

Category

provider

Production DDL — DIM_PROVIDER

DIM_PROVIDER.sql
CREATE OR REPLACE TABLE DIM_PROVIDER (
    prvdr_key           INTEGER        NOT NULL  -- surrogate key,
    prvdr_npi           VARCHAR(10)              -- NPI number,
    prvdr_tin           VARCHAR(10)              -- tax ID number,
    prvdr_first_nm      VARCHAR(100)             -- first name,
    prvdr_last_nm       VARCHAR(100)             -- last name,
    prvdr_org_nm        VARCHAR(255)             -- organization name,
    prvdr_typ_cd        VARCHAR(20)              -- provider type code,
    prvdr_spclty_cd     VARCHAR(10)              -- specialty code,
    prvdr_tax           VARCHAR(10)              -- taxonomy code,
    prvdr_state_cd      CHAR(2)                  -- state code,
    prvdr_zip_cd        VARCHAR(10)              -- zip code,
    prvdr_ntwk_sts      VARCHAR(10)              -- network status,
    prvdr_accpt_pt_ind  CHAR(1)                  -- accepting patients,
    prvdr_excl_ind      CHAR(1)                  -- exclusion indicator,
    load_dt             TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical provider table. Convert to BigQuery or Databricks →

Why This Term Matters

Provider data management is one of the most operationally complex data domains in healthcare because providers move, merge, and update their credentials continuously. A data engineer who understands provider terminology can build NPI validation, credentialing, and network adequacy pipelines that keep provider directories accurate and prevent claim rejections. Stale or incorrect provider data is a leading cause of prior authorization delays and CMS compliance findings.

Related Content

Looking for more healthcare terms?

Browse our complete library of 100,000+ standardized healthcare data terms

Browse All Terms