The CAQH (The Council for Affordable Quality Healthcare, Inc.), is only one of many tools utilized in the provider enrollment process by participating health plans. You need to know that enrolling with the CAQH will not enroll you with all health plans.
Yes, the process of enrolling with the CAQH can be confusing and time consuming. That’s where we come in …
We request your CAQH ID*, create a user name and password and complete your ProView profile (which can be 15 pages or more of detailed information). All are necessary before a participating insurance company can access your data for credentialing. * To obtain a new ID, a request must be made via a participating organization to be placed on their roster. This health plan will determine whether or not they will issue a CAQH ID to a practitioner based on their network needs and credentialing criteria.
Once your CAQH profile has been completed and all documents have been uploaded, then maintaining your CAQH profile becomes a necessity.
On-going maintenance plans (if chosen), include(s): Re-attestation (as required by the CAQH), updates, revisions, ads and deletions so the participating insurance networks have access to correct and up to date credentialing information.
What is the CAQH?
The CAQH is an online data repository of credentialing data. That can include demographic, education and training, work history, malpractice history, and other relevant credentialing information for insurance companies to access.
Remember, the longer you wait, the longer it takes to get reimbursed for your services.