AssureCare Medical Credentialing and Enrollment is a cloud-based software platform designed to streamline and automate the credentialing and enrollment process for healthcare providers, with specialized support for pharmacies and pharmacist providers. The platform verifies provider qualifications, manages payor enrollment, confirms active licenses, and monitors compliance with regulatory requirements. It addresses the unique needs of pharmacists offering clinical services, including pharmacy-specific credentialing and evolving practice regulations. The system supports ongoing re-credentialing, ensuring providers maintain eligibility with payors and regulatory agencies. Advanced analytics and integration with medication management and clinical programs enhance operational efficiency, expand referral networks, and improve patient outcomes. The platform is designed to lower costs, maximize revenue, and support the expansion of clinical services in pharmacy settings.

Key Features

Provider Credentialing Automates verification of provider qualifications, background, and experience.

• Ensures compliance with industry and pharmacy-specific standards
• Supports credentialing for clinical pharmacy services

Payor Enrollment Streamlines provider enrollment with insurance payors.

• Facilitates approvals for medical billing and reimbursement
• Navigates complex pharmacist provider enrollment requirements

License Verification Confirms active and up-to-date provider licenses.

• Integrates state and national regulatory checks
• Ensures compliance with scope of practice regulations

Compliance Monitoring Tracks adherence to credentialing, licensing, and regulatory requirements.

• Mitigates risk and maintains operational integrity
• Adapts to evolving pharmacy practice regulations

Re-credentialing Management Manages ongoing credentialing requirements and timelines.

• Maintains provider eligibility with payors and agencies
• Addresses unique re-credentialing needs for pharmacists

Advanced Analytics Provides insights into credentialing, enrollment, and compliance processes.

• Supports data-driven decision-making
• Enhances workflow efficiency and reporting

Benefits

Operational Efficiency Streamlines credentialing and enrollment workflows.

• Reduces manual workload and administrative burden
• Accelerates provider onboarding and payor approvals

Improved Compliance and Risk Mitigation Ensures regulatory and licensing adherence.

• Minimizes compliance risks and errors
• Maintains up-to-date provider records

Expanded Clinical Services and Revenue Opportunities Supports pharmacy expansion into clinical services.

• Enables billing for clinical pharmacy services
• Diversifies revenue streams and increases referrals

Enhanced Patient Outcomes Improves access to qualified providers and clinical services.

• Supports better care coordination
• Facilitates timely provider onboarding