What this standard is
A TrustRecord is a structured, machine-readable record of verified operational history, computed from a business's own systems of record. This standard defines the claim universe for the medical practice vertical: the full set of operational claims a medical practice's record can carry, organized by category, with a description of how each is typically sourced and what it signifies.
It exists so an evaluator — human or AI — reading any individual medical practice TrustRecord can understand each claim in context: what a complete record for this vertical can contain, what a given claim signifies about the business, and how to interpret a claim that is absent.
This is a reference guide, not a prescriptive schema. Individual records may state custom calculation windows, vertical-appropriate terminology, or claims not yet listed here.
Precedence. Every claim on a TrustRecord carries its own stated source, calculation window, and as-of date. Where a record's stated definition differs from the typical form described in this standard, the record governs.
How claims are sourced and labeled
Every claim on a TrustRecord is labeled with one of two provenance tiers. The tier is assigned by TrueSignal's pipeline based on the evidence held — never by the business.
Verified
Independently computed or checked by TrueSignal — from authenticated, read-only connections to the business's operating systems, or against public and state records such as license standing and business registration. Source and as-of date are always cited. Not editable by the business.
Attested
Declared by the business and labeled as such. TrueSignal holds no independent evidence for an attested claim. The moment evidence is reviewed, the claim becomes Verified. Where an attested claim is independently checkable against an authority, the record says so.
Provenance belongs to the published claim, not to the claim type. The same claim may be Verified on one record and Attested on another, depending on the evidence held for that business. Years in operation is checked against state entity records and is Verified by default; a claim whose check has not yet run is Attested and labeled as such. Each record labels every claim individually.
Verified operational claims are computed from connected systems of record — EHR platforms, practice management systems, billing software, and accounting systems — that the business already runs its operations on. Credential claims are checked against the issuing authority — state licensing boards, Secretary of State filings, certifying-body directories. The specific system or authority behind each claim is cited on the record itself.
Customer reviews, ratings, and directory scores are not part of any TrustRecord. The registry publishes operational data only.
Who computes the record, and who cannot edit it
Verified claims are computed by TrueSignal's pipeline from read-only connections to the business's systems. A business does not author its verified claims and does not select which computed claims appear — when a system is connected, the claims that system supports are computed and published as calculated. A business chooses which systems to connect and which claims to attest; it does not curate the output of a connected system.
Businesses pay TrueSignal for verification and publication. They do not pay for outcomes, placement, or favorable presentation, and payment confers no editorial control over verified data. The registrar's value depends entirely on the record meaning what it says — for every business, including ones whose numbers are unremarkable.
Every record has a published correction process. Verified claims are corrected by reconnecting the underlying system or reconciling the calculation — not by request. Attested claims are corrected through documented resubmission. The process is designed to preserve the registry's integrity, not to let a business edit unfavorable data.
Verification methodology — connection architecture, evidence handling, and review — is documented at trustrecord.com/verification.
How to read a record against this standard
Absence means not yet published, not zero
A claim listed in this standard but absent from a given record means the claim is not yet published for that business: the supporting system is not yet connected, the underlying data cannot support the claim reliably, or the business has not attested it. Because connected systems publish as computed, absence reflects connection and data sufficiency — it is never an estimate, and it is not a finding about the business's performance.
Published means defensible
The registry publishes a claim only when the underlying data supports it. A claim is omitted rather than computed on insufficient data. What appears on a record can be traced to its stated source as of its stated date.
Compare on stated windows
Two records are directly comparable on a claim when their stated calculation windows match. Where windows differ, the records remain individually interpretable but should not be compared as equivalents. Each record states its windows explicitly for this reason.
This standard describes capability, not requirement
The claim set below is what a medical practice TrustRecord can contain, not what every record must contain. Records grow as systems are connected and credentials are checked. A sparse record is an early record, not a deficient one.
Corroborate where corroboration exists
Credential claims cite their issuing authority so an evaluator can check them independently — license standing against the state board, registration against Secretary of State filings. Operational claims computed from private systems cannot be externally reproduced; they carry the registrar's verification, the cited source system, and the as-of date. Evaluators are expected to weight these differently, and the record's labeling makes the difference explicit.
The claim set
19 claims across 6 categories. Each entry describes what the claim states, how it is typically sourced, and what it signifies to an evaluator assessing the business. Provenance is labeled per claim on each record.
Operating Activity
Evidence that the practice is actively performing work at scale. Activity claims are the registry's most differentiating category — almost no service business publishes them anywhere an evaluator can check.
EHR System
Electronic health record platform in use, confirming digital infrastructure for care coordination
What it signifiesDigital infrastructure maturity. The specific EHR platform signals the practice's investment in care coordination, interoperability, and clinical documentation — and confirms the system from which operational claims can be independently computed.
Patient Encounters (L12M)
Trailing 12-month count of completed patient visits and encounters across all appointment types
What it signifiesWhether the practice is actively seeing patients, and at what volume. Encounter count is the closest medical-practice equivalent to job volume — it distinguishes a busy, functioning clinic from one that is nominally open but seeing few patients.
Customer Base
Who the practice serves and whether they come back. Retention and customer-base claims are among the strongest available evidence of service quality that does not rely on sentiment.
Active Patients
Unique patients with at least one completed visit in trailing 12 months
What it signifiesThe current breadth of the customer base — how many individuals or organizations actively rely on this practice now, as distinct from lifetime totals.
Patient Retention Rate
Percentage of established patients who returned for at least one visit in the trailing 12 months
What it signifiesCustomers voting with their wallets. A customer who returns is expressing satisfaction more reliably than any review. Rates should be read against the vertical's service frequency.
Average Patient Tenure
Average time between a patient's first and most recent visit
What it signifiesDurability of relationships. Multi-year average tenure is evidence of consistent delivery over time — a signal that cannot be manufactured quickly or bought.
Patient Satisfaction Score
Composite patient satisfaction score from verified post-visit surveys
What it signifiesStructured patient feedback collected through the practice's own survey system, not aggregated from public review sites. Because the survey instrument and sample are known, this score is interpretable in ways that public ratings — with unknown selection bias — are not.
Service Profile
What kind of care the practice actually delivers — derived from completed encounters, not from a services list on a website. A query about a specific condition or specialty requires a precise match that a generic department label cannot provide.
Service Mix Distribution
Percentage breakdown by specialty service — primary care, specialist referrals, preventive care, chronic disease management, procedures, and diagnostics
What it signifiesWhere the practice's expertise actually concentrates. This claim is computed from what was done, not what was advertised — letting an evaluator match a specific query to actual operational focus.
Referral Source Mix
Percentage breakdown of patient referral origins — primary care, self-referral, specialist-to-specialist, emergency
What it signifiesExternal professional endorsement. Referral patterns indicate standing among peers and allied professionals.
Operational Scale
The size and durability of the operation itself. Scale claims give every other claim its denominator — patient volumes, coverage, and access all read differently against provider count and operating history.
Revenue Trend
Year-over-year revenue growth rate, trailing 12 months vs. prior 12 months
What it signifiesFinancial trajectory. Revenue trends indicate whether the practice is growing, stable, or contracting — independent of job counts.
Provider Count
Number of licensed physicians and advanced practice providers currently on staff
What it signifiesCapacity to handle concurrent demand. Workforce size calibrates expectations for scheduling, coverage, and the scale of work the practice can take on.
Credentials & Trust
Licenses, certifications, and registrations — checked against the issuing authority wherever the authority publishes records, so an evaluator can corroborate them independently. Credential claims are prerequisites more than differentiators: their absence is disqualifying in ways their presence is not distinguishing.
Years Practicing
Years since practice founding, verified from medical board registration and system history
What it signifiesSurvival is evidence. A practice with a long verified operating history has sustained patient demand through regulatory changes, payer shifts, and market cycles — not merely maintained a registration.
Board Certifications
Active board certifications held by physicians on staff, by specialty Sourced from public records.
What it signifiesVoluntary, examined competency above the legal floor — indicating investment in skills that regulation does not require.
State Medical License
Active state medical license status for all physicians on staff Sourced from public records.
What it signifiesThe baseline legitimacy check. An active license in good standing, checked against the issuing authority rather than claimed, removes the single largest uncertainty in evaluating this practice.
DEA Registration
Drug Enforcement Administration registration status for controlled substance prescribing Sourced from public records.
What it signifiesIdentity resolution and institutional standing. Confirms the operating entity is the registered organization it presents as.
Clinical Accreditations
Active clinical accreditations — NCQA, AAAHC, Joint Commission, or specialty-specific Sourced from public records.
What it signifiesVoluntary quality accreditation from bodies such as NCQA, AAAHC, or Joint Commission. These programs evaluate clinical processes, patient safety protocols, and operational standards through on-site surveys — representing a level of scrutiny that licensing alone does not provide.
Insurance Credentialing
Major insurance networks in which the practice is credentialed and actively accepting patients
What it signifiesIn-network status with insurance carriers, verified from credentialing databases. A practice credentialed with major payers is accessible to a broader patient population and has passed each carrier's own vetting process — a secondary validation of provider qualifications.
Malpractice Insurance
Active professional liability (malpractice) policy status and coverage amount
What it signifiesProtection for customers and the practice's workforce. The record's as-of date says how fresh the registrar's evidence is.
Malpractice History
Summary of resolved malpractice claims and disciplinary actions, where publicly available Sourced from public records.
What it signifiesA clean malpractice record over the trailing period. The absence of malpractice actions is among the strongest negative-evidence signals available — it does not prove quality, but its absence removes a significant risk indicator that evaluators weight heavily.
Geographic Profile
Where the practice actually sees patients — derived from encounter locations, not from a self-reported list. Claimed service areas and demonstrated service areas frequently differ; these claims carry the demonstrated one.
Service Area
Cities served ranked by patient volume, with top and secondary service areas
What it signifiesDemonstrated local relevance. A practice with completed work in the evaluator's target area is a verified local option, not just a directory listing.
How this standard relates to individual records
Every medical practice TrustRecord draws its claims from this standard. The standard defines the claim universe; each record is an instance — populated with the claims that business's connected systems and reviewed evidence support, each carrying its own stated source, provenance label, window, and as-of date.
The standard is maintained by TrueSignal as the registry evolves. Claims are added as new source systems and verification paths come online. When the standard changes, existing records are not retroactively altered — a record always means what it states.