A CAQH profile lets you maintain professional and practice information in one place and share it with participating organizations you authorize. It supports credentialing, but creating a profile does not make you in-network with a payer.
This guide explains what CAQH does, who uses it, how to register, and how to keep your information current. Start with your payer’s requirements, then use the sections below to find the help you need.
Need help organizing your CAQH work? Schedule a conversation with PPS about profile setup, maintenance and the payer tasks that remain.
Working through this yourself? Start with our credentialing document checklist.
What should you check before a payer reviews your profile?
Start with the information that changed since your last review. A new location, renewed policy or different contact person deserves a check even when your next attestation is months away.
- Confirm account access. Make sure the provider can reach the account and its recovery email. If staff have changed, review who should still have access. Use the portal's supported delegation options rather than putting a password in your application tracker.
- Compare documents with profile fields. Check that names, license details, practice addresses and coverage dates agree with the current supporting documents. A new upload is a reason to review the related fields, not assume they updated automatically.
- Check organization access. Look for the specific participating organization that requested your information. Ask the payer which organization name to authorize if the listing is unclear.
- Review and attest. Resolve the portal's outstanding items and follow its review instructions. Record the resulting status and the next deadline shown in the account.
- Close the loop with the payer. Record who will follow up, when, and what the payer still needs. An updated profile is not evidence of a contract or effective date.
For a simple internal worklist, use four columns: item to correct, responsible person, target date and completion evidence. Keep sensitive documents in your approved secure system rather than copying them into an ordinary shared checklist.
DataSpring's provider portal fact sheet describes document uploads, organization authorization and staff delegation. Use the current portal instructions for your account; this checklist is a suggested practice workflow.
Your profile, in brief
- Confirm the profile and documents each payer needs.
- Keep information current and authorize access.
- Track payer applications and decisions separately.
What is CAQH?
CAQH stands for the Council for Affordable Quality Healthcare. The organization has rebranded as DataSpring, powered by CAQH. The CAQH Provider Data Portal remains the place to manage your professional profile; existing access and account information remain in place.
The portal, previously known as CAQH ProView, supports the exchange of information used in credentialing and provider directories. DataSpring also offers credentialing, verification and other administrative services. For this guide, the focus is your provider profile and the information you share with payers.
What is CAQH used for?
CAQH has changed over the years, but its core purpose is to simplify information sharing. Think about your license, malpractice certificate or other documents that need periodic updates. You can maintain them in your profile so authorized participating organizations can access them, instead of handling every request from scratch.
Do not assume every payer will retrieve your profile. Confirm whether each plan participates, whether you have authorized it, and what additional application steps it requires. A CAQH profile supports the information-gathering process; it does not replace a payer’s credentialing decision, contract or enrollment approval.
Requirements vary by plan and product. Avoid a blanket assumption about Medicaid, TRICARE or Medicare Advantage participation. Ask the specific plan how it collects credentialing information.
Who should enroll with CAQH?
Providers whose health plans or other organizations request a CAQH profile should register or maintain their existing account. Physicians, nurse practitioners, physician assistants, therapists, dentists and counselors may use the portal, depending on the organizations they work with.
Participation is voluntary, although a payer may request it as part of its process. A cash-only practice or a provider billing out-of-network should still check relevant payer or organizational requirements rather than assume a profile is unnecessary. See the official provider FAQs.
How does CAQH relate to provider credentialing?
CAQH profiles can support both initial credentialing and recredentialing. This is not a “set it and forget it” database. Participating payers may request your CAQH ID and retrieve your information after you authorize access.
Once your practice is operating, keep your profile current for future reviews. Track each payer’s requirements, submission status and effective dates separately. Our credentialing and enrollment comparison explains why these steps are related but distinct.
Back to contents ↑How do I reset my CAQH password?
Use Forgot Password on the provider sign-in page. Enter the requested account information, then follow the email reset instructions. If you have also forgotten your username, use the username-recovery option first.
How do I update my primary email address?
You may not recognize the email address on file if a former employer or administrator created your profile. Follow the account-recovery instructions in the portal. If you cannot access the email on file, contact provider support for help verifying your identity and recovering access.
If the self-service process does not resolve the issue, contact provider support at 888-599-1771. Keep your CAQH ID available.
Does CAQH credentialing cost money?
Providers can create, maintain and share a profile through the CAQH Provider Data Portal at no charge. Paid assistance from PPS is a separate service.
Health plans and other participating organizations pay for the administrative services they use. There is a distinction between free access to the portal and hiring a credentialing team to help manage your work.
How do I update my CAQH profile?
Sign in and review the profile categories, including personal information, professional IDs, education, practice locations and supporting documents. Correct information that has changed, replace expired documents and complete the review and attestation process. Check that the intended organizations are authorized to access your profile.
How often does CAQH need to be updated?
CAQH’s standard re-attestation interval is 120 days, or 180 days for providers practicing in Illinois. This is not the same as once a quarter. Directory-confirmation requests may follow a separate quarterly schedule. Follow the due dates shown in your account.
Update the profile when information changes, even if the attestation deadline is still ahead. We recommend a monthly check for missing information, new documents and payer requests. See the official DataSpring FAQs for the attestation and directory-confirmation requirements.
Why should I register with CAQH?
A profile can reduce repeated data entry when several participating plans need the same information. It also gives your practice a central place to maintain documents and authorizations.
Use the portal alongside your payer application tracker. Before treating a task as complete, confirm what the payer still needs and whether its review or enrollment is approved.
How do I find my CAQH ID?
Check for an existing profile before creating another account. Use the account-lookup or registration options on the CAQH provider portal and supply the identifying information requested.
If an existing account is found, recover access to that account. If another organization set it up and you cannot recover it, contact provider support instead of creating a duplicate profile.
If no profile exists, continue with registration and keep the assigned ID with your practice’s credentialing records.
How do I register with CAQH?
- Gather your documents. Prepare your current CV and the items applicable to your profession and practice, such as licenses, malpractice coverage, DEA or controlled-substance certificates, a W-9, board certification and hospital privileges. Use the portal’s document requirements to confirm what you need.
- Prepare professional and practice information. Have references available if requested. New practices should organize legal entity information, tax ID, practice addresses, relevant NPIs, hours, phone numbers, and billing and credentialing contacts.
- Register and complete your profile. Start at the CAQH Provider Data Portal. Work through the requested categories and address missing information before submitting your profile for use.
- Review and attest. Check that the information is accurate and complete. Follow the portal’s attestation and supporting-document instructions; upload additional releases only when required for your application.
- Authorize access. Grant the appropriate participating organizations access to your information. Confirm directly with each payer that it has what it needs and complete its separate application steps.
- Maintain your account. Store account access securely, keep your contact email current, and set reminders for document expiration and the attestation deadline. Do not rely only on reminder emails.
What is CAQH credentialing?
“CAQH credentialing” commonly refers to preparing and maintaining the provider profile used in a payer’s credentialing process. A complete profile is an important input, but it does not establish network participation or authorize billing by itself.
Instead of sending the same information repeatedly, you can share your profile with participating organizations you authorize. Keep a separate record of payer applications, follow-up requests, contracts and approvals.
PPS can help with CAQH profile setup and maintenance, insurance credentialing, payer contract negotiations and practice start-up planning. We can help you identify the work required and organize the next steps.
For current instructions and training, use DataSpring’s clinician resources. Screen labels can change as the portal is updated.