Licensing & Credentialing
PBM Credentialing
The process of completing and maintaining the applications, documents, and verifications a Pharmacy Benefit Manager requires for a pharmacy to join and stay in its network.
In depth
Credentialing packages typically bundle licensure, DEA registration, insurance, ownership disclosures, and accreditation evidence, each with its own expiration. Because PBMs revalidate periodically and a single lapsed document can suspend network status (and therefore revenue), pharmacies track credentialing items with expiry reminders and a document vault. Missing or expired credentialing is both a revenue risk and an audit risk.