provider termination
prvdr_term_indDefinition
ISO-11179 Definition
An indicator or coded value identifying that a healthcare provider network participation has been terminated, either voluntarily through mutual agreement or contract expiration, or involuntarily by the health plan for cause including quality concerns, fraud, compliance violations, or loss of licensure. Provider termination triggers member notification obligations under CMS and state regulations, typically requiring 30 to 60 days advance notice when possible to allow members to transition care. Involuntary terminations for cause may require immediate action without advance notice.
Healthcare data teams track provider termination events with termination dates, reason codes, and member impact assessments in network management systems, build member notification workflows triggered by termination events, and maintain termination history for compliance documentation and network analytics tracking provider attrition patterns over time.
Standard Abbreviation
prvdr_term_ind
Category
Production DDL — DIM_PROVIDER
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
Related Definitions
Looking for more healthcare terms?
Browse our complete library of 100,000+ standardized healthcare data terms
Browse All Terms