CAQH

What is CAQH?

CAQH or th Council for Affordable Quality Healthcare is an online portal that stores provider information in a secure database.  Access to this secured information is granted to health insurance companies during the credentialing process to make acquiring up-to-date provider information more efficient.  CAQH stores valuable provider information such as Medical License and work history, making it simple to obtain accurate data.  90% of the National Health Insurance Companies use CAQH as it is a prerequisite for the insurance enrollment process in most states.

The mission of CAQH is to improve health care access & quality for patients, and at the same time, reduce the paperwork and hassle for health care providers and their office staff.

As you know, the insurance credentialing process can be arduous with all of the various credentialing applications and insurance carriers.  It’s stressful and time consuming to go through each insurance company's unique credentialing process.  This is where centralizing your information in a streamlined platform becomes so helpful to the accessing provider information rapidly.

What is CAQH Attestation?

Attesting your CAQH profile is the process of signing off on your CAQH application at the end of the application process.  In addition to initially attesting, you must re-attest every 90 days which keeps your application active and provides your contracted insurance carriers with up-to-date credentialing information.  Failure to attest your CAQH application will result in your credentialing / recredentialing applications with the payers being delayed or rejected.  It’s critical that you keep up with your CAQH profile and ensure your information is accurate.  Every time you receive a new malpractice policy, license, DEA certificate, W9 or address, it’s critical that you upload this information in CAQH.

What is the CAQH Credentialing Process?

Outlined below are the steps you’ll take to complete the CAQH credentialing process.  If you don’t have the time or energy to deal with it, we can actually complete all of these steps for you and eliminate one more thing from your plate.  Not having a completed CAQH application will delay your enrollment with the insurance companies, preventing you from getting reimbursed for your services.  

UNDERSTANDING THE CAQH CREDENTIALING PROCESS

  1. Obtain your CAQH ID by contacting an insurance company or completing the online enrollment process with CAQH
  2. Set up your secure username and password
  3. Complete the online application and send in the required documentation
  4. Complete and sign the attestation form which certifies the accuracy of your application
  5. Grant insurance companies access to your online application
  6. You are now ready to start the credentialing/contracting process with the insurers.

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