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. Aisha Grant, MD
CredentialPayer enrollment (BLUE)
NumberBLUE-ENR-DEMO-4067
Issued byBluestem Mutual
Valid fromJun 25, 2025
Valid throughJun 25, 2028

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