The Role of CAQH in Credentialing: A Step-by-Step Guide
If you’re a healthcare provider beginning the credentialing process, chances are you’ve heard of CAQH—but you may not know exactly what it is or why insurers require it. Understanding CAQH is key to getting credentialed quickly and avoiding unnecessary delays.
This guide breaks down what CAQH is, how it works, and how you can use it to streamline your credentialing journey.
What is CAQH?
CAQH stands for the Council for Affordable Quality Healthcare. It’s a non-profit alliance of health plans and trade associations that created the CAQH ProView portal, a centralized database where providers enter their professional and practice information.
Instead of sending your credentials separately to every payer, CAQH allows you to maintain one comprehensive profile that insurers can access directly.
Think of it as a one-stop shop for credentialing data.
Why Do Insurers Require CAQH?
Insurance companies use CAQH to:
Verify provider information: Licenses, education, certifications, work history, malpractice coverage, and more.
Save time and reduce paperwork: Instead of requesting the same documents from you individually, they pull everything from your CAQH profile.
Ensure compliance: A standardized process helps insurers meet regulatory requirements while making onboarding smoother for providers.
Without a completed and up-to-date CAQH profile, most insurers won’t process your credentialing application.
Step-by-Step: How CAQH Works in Credentialing
Step 1: Receive Your CAQH ID
You can request an ID directly at caqh.org.
Occasionally, your place of work may obtain an ID for you, however your profile will often be incomplete.
Step 2: Create Your CAQH ProView Profile
Register with your CAQH ID.
Enter details like education, training, licenses, certifications, malpractice history, and practice locations.
Upload supporting documents.
Step 3: Attest to Your Information
Once your profile is complete, you must attest that your information is accurate.
Attestation is required every 120 days (about every 4 months). Honored Healthcare can keep track of your attestation dates for you and complete them when they are due.
Step 4: Authorize Payers to Access Your Profile
Log into CAQH and grant access to each insurance company you want to credential with.
If you don’t authorize them, they can’t view your data.
Step 5: Maintain and Update Regularly
Update your profile anytime something changes—license renewals, malpractice coverage, or new work history.
Set reminders to re-attest on time to avoid interruptions.
Pro Tips for Using CAQH Effectively
Keep all your documents in a cloud folder so they’re easy to upload.
Double-check spelling, dates, and details—errors can cause major delays.
Don’t wait until a payer requests access; proactively keep your profile current.
Mark your calendar for quarterly CAQH attestations.
Final Takeaway
CAQH is the backbone of modern credentialing. It simplifies the process for both providers and payers, but only if you use it correctly and keep your profile updated. By mastering CAQH, you’ll avoid unnecessary delays and get approved with insurers faster.
Overwhelmed by CAQH updates and attestations? Honored Healthcare Systems can manage the process for you so you never miss a step. Contact us today to get started.
