Platform
Credentialing that reads, fills and chases — so your team decides
Clarvera is built as an AI operational workflow, not a credentialing database. The AI reads the documents you already receive, fills the provider record and flags what is missing; agents take the chasing and the reconciliation off your team entirely. Everything below is the real list, and where something is still being built, this page says so.
AI assist
Every planAI that reads the documents and fills the record
Document to structured profile
Point it at the licence, the certificate or the CV you already received and it reads them into the provider's record, with field-level confidence on each value rather than a silent best guess.
Gaps, duplicates and conflicts
Missing-data detection, duplicate detection and conflict flagging across the record, surfaced as something to decide rather than applied quietly.
Suggests; a person commits
Nothing here writes to a credentialing file on its own. It proposes, and someone accepts. It removes the typing, which is the work the price is actually for, and it is included in every plan, Core too. Fair-use limits apply.
Autonomous AI
EnterpriseAgents that act without a human in the loop
Agentic provider outreach
Chasing missing documents and attestations directly with the provider, rather than generating a task for someone else to chase.
Automated roster reconciliation
Differences resolved across counterparties without a person driving each one.
Change detection and orchestration
Changes detected, notified and carried into the workflow they affect.
Advanced analytics
EnterpriseWhere the time actually goes
Turnaround and bottlenecks
Turnaround analytics and bottleneck attribution across files, so a slow cycle has a named cause rather than a feeling.
Benchmarking and forecast
Cross-tenant benchmarking and forecasting for organisations operating at a scale where the trend matters more than the file.
Directory
Every planThe provider's verified record, kept current
A real credential record
Licences, DEA registrations, board certifications, education and training, work history, malpractice cover, specialties, affiliations and collaborative agreements. Each is an expiry-aware record rather than a filed document.
NPI checked against NPPES
NPI numbers are checked against the public NPPES registry at the point of entry, so a record starts from the federal source rather than from typing.
Document vault
Certificates, face sheets and CVs stored encrypted and versioned against the provider they belong to, and virus-scanned on upload.
Portable, and consent-governed
The clinician's record is theirs. Organisations read it by recorded consent, and it survives a change of employer, and it is the record a Core plan holds.
Credentialing
Intelligence and EnterpriseApplications, PSV, committee, re-credentialing
Credentialing files
Open a file, assemble it, carry it to a committee decision, and keep the decision beside the evidence it was made on. Re-credentialing runs on its own cycle rather than on a reminder.
PSV element tracking
Every element a file needs, tracked individually: verified status, discrepancies, waivers, an append-only source contact log, and who confirmed what, when, and against which source.
NCQA standards
Standards tracked against the file, with verification reports and evidence a surveyor can be walked through.
Queue and assignment
Work distributed across a credentialing team, with engagement-level views for an organisation operating across clients.
Automated primary-source queries
In developmentFSMB, NURSYS and NPDB clients are written and waiting on the credentialed data agreements each source requires. Until those are in place your team records results against the elements above. The tracking is live, the automated query is not.
Monitoring
Every planThe checks that cannot be allowed to lapse
OIG and SAM exclusion screening
Screened against the OIG LEIE list and SAM.gov. Wired to the real sources: OIG publishes its list publicly and SAM.gov is queried with a registered key.
Monthly sweep
A scheduled sweep re-screens every active provider rather than relying on anyone to re-run it, and keeps the full check history. A billing state cannot switch it off.
Expiry tracking
Licences, DEA registrations and certifications carry expiry dates, and the record surfaces what is lapsing before it lapses.
Enrolment
Intelligence and EnterprisePayer enrolment, tracked like credentialing
Medicare, Medicaid and commercial
Enrolment applications tracked per payer with their own states and evidence, rather than as a spreadsheet beside the credentialing file.
Revalidation
Medicare revalidation cycles tracked against the provider record, so the deadline is visible before it is missed. Medicare and Medicaid enrolment is also part of Core; commercial payers are on Intelligence.
Roster exchange
Intelligence and EnterpriseGetting the roster to the other side
Roster generation and reconciliation
Rosters generated with per-counterparty layouts and reconciled on return, so a roster leaves in the format the receiving side expects and differences are visible.
Provider directory
Directory at location, network and product grain: the shape payors and networks actually publish and audit against.
FHIR R4 surface
FHIR endpoints for provider directory data, built against the CMS Interoperability Rule and the 21st Century Cures Act.
Delegation and operator
EnterpriseFor CVOs, health plans and delegated entities
Delegation oversight
Pre-delegation evaluation, annual audit and corrective action plan tracking: the oversight obligations delegation actually carries.
Operating across client tenants
One operator working across client organisations with hard per-client walls, client engagements, consent tracking and contracts modelled rather than kept in a spreadsheet.
Network adequacy and quality
Adequacy tracking, quality metrics, standards and reporting for network operators.
Single sign-on
SAML single sign-on against your own identity provider.
Trust
Every planWhat an auditor asks for
WORM audit trail
Every PHI access, decision and export written to an append-only log. No application role holds UPDATE or DELETE on it. Six-year retention.
Tenant isolation at the database
Row-level security enforced in Postgres, not in application code. A query without a bound tenant returns nothing, asserted by tests running as the restricted runtime role.
Roles, consent and the BAA gate
Role-based access with custom roles, consent recorded per grant, and a BAA that takes effect before any PHI enters the system.
Break-glass access
Clarvera staff access to tenant PHI requires break-glass authorisation tied to an open ticket, and every access is logged and reported to your admin.
See every feature on your own data
14-day free trial. No credit card required, BAA signed first.