The Importance of Your Providers’ CAQH Profiles

These days, insurance credentialing and an up-to-date CAQH profile go hand-in-hand. The Council for Affordable Quality Healthcare (CAQH) is a non-profit collaborative alliance of the country’s leading health plans and networks. This online database offers a one-stop shop for insurance payors to access information about each provider with a profile.

Because so many payors are now using CAQH as part of the credentialing process, it’s vital that providers’ profiles stay as current and accurate as possible. For some payors, the initial credentialing/enrollment process is much less complicated when a provider has a CAQH profile. Having a CAQH profile can tremendously cut down on paperwork because most required information for enrollment can be found through CAQH.

CAQH requires review and re-attestation every 120 days, but it’s beneficial to make updates anytime they occur. For example, a renewed malpractice policy or license should be updated in a provider’s CAQH profile as soon as possible, as payors may access that information if re-credentialing and re-validation is near. Maintaining a re-attestation schedule on your calendar is not only useful, but extremely important for all of your providers.