SAMPLE for the demonstration: a fictional certificate, not a real document. In real use this is the scan or PDF the coordinator attaches.

Payer enrollment

Ridgeline Health Partners credential file

Issued toDr. Owen Hale, MD
CredentialPayer enrollment (HARB)
NumberHARB-ENR-DEMO-4010
Issued byHarborline Health
Valid fromNov 24, 2025
Valid throughNov 24, 2028

Fictional provider and number. Close this tab to return to the Credential Tracker.