Welcome to the Pharmacy Provider Portal. We’re dedicated to bringing you the information you need to best care for your patients.

Here you can quickly access processing information, pharmacy enrollment requests, electronic pay information, MAC disputes and more.

The Annual Pharmacy Attestation can be found here.

For additional questions, please call our Pharmacy Help Desk at 1-800-361-4542 or contact us.

Processing Information

Enrollment for Independent Pharmacies

How to become a Participating Pharmacy in the EnvisionRx Network:

There is a 2 step process described below in order to become a Participating Pharmacy.

  1. Enrollment and Credentialing Process:
    • Complete the Independent Pharmacy Enrollment Application.
    • Submit completed application, with all applicable fields populated and requested documents included, via email to or by fax 330-405-8094.
      • Please note, completion of an application does not guarantee access into the EnvisionRx Network. Applications submitted without all fields completed or required documents attached will not be processed.
    • Once your completed application is submitted, please allow 10-15 business days for your application and documentation to be processed by our Network Credentialing Team.
    • If you have additional questions or have not received a response within 15 business days, please send an email to with “APPLICATION STATUS” in the subject line and please be sure to include:
      • Pharmacy NCPDP number
      • Date of initial Independent Pharmacy Enrollment and Credentialing Application submission and a note of whether it was faxed or emailed
      • Current copy of the pharmacy’s Certificate of Liability Insurance
      • Envision credentialing and re-credentialing FAQ’s

  2. Contracting Process:
    • If your pharmacy passes our credentialing process, a member of the Provider Relations Contracting Team will reach out to you with a Participating Provider Agreement.
    • Once the signed Participating Provider Agreement is submitted back to us, please allow 7 to 10 business days for the Agreement to be executed and implemented.

For all other inquiries, please contact the EnvisionRx Pharmacy Help Desk toll-free at 1-800-361-4542.

Electronic Payment & Remittance

We are happy to provide our participating pharmacies with the opportunity to receive payment electronically via ACH and remittance details electronically in HIPAA 835 format.

You must submit all forms in order for your request to be processed! Please contact us at with any questions.


MAC pricing is available to pharmacies upon request via calling the help desk at 1-800-361-4542 or emailing

Pharmacies may contact us with MAC concerns at or through the EnvisionRx Pharmacy Help Desk at 1-800-361-4542. Appeals will be responded to within seven business days.

Pharmacies are requested to provide the following to ensure that requests can be reviewed without any disruption:

  • RxBIN
  • GroupID
  • Rx number
  • Date of fill
  • NDC
  • Drug and strength
  • Quantity dispensed
  • NCPDP number
  • Acquisition cost
  • Contact name and number

Pharmacy Satisfaction Survey

Please take a minute to complete our Pharmacy Satisfaction Survey. Your responses will be kept confidential. It is through your honest feedback that we can improve our services to you. It will only take a few minutes to complete.