What is CAQH? Council for Affordable Quality Healthcare.  It is essentially an online database that stores provider information.  This information is granted to health insurance companies to make acquiring provider information more efficient.  Instead of calling your office for your work history or a copy of your Medical License, they can go in and pull it directly from your file.  90% of the National Health Insurance Companies use CAQH and it is a prerequisite for their enrollment process.

There are three steps to getting set up in CAQH which are outlined below.  We can actually complete all of these steps for you without needing to wait on an insurance company to issue your ID.  Not having a completed CAQH application will delay your enrollment with the insurance companies, preventing you from getting reimbursed for your services.  Our ability to obtain your ID in time is due to our relationships with the insurance companies which do not give us the run around like they do when most providers call.

CAQH Credentialing Process

  1. Obtain your CAQH ID (Our average 3-4 business days; When going through insurers 4-5 weeks)
  2. Set up your secure username and password
  3. Complete the online application and send in the required documentation
  4. Send you attestation for signature which certifies the application
  5. Grant insurance companies access to your online application
  6. You are now ready to start the credentialing/contracting process with the insurers.

Estimated Time for Completion: 5-7 Business Days

Costs

We charge $200.00 per CAQH application for new providers who do not have a CAQH ID and $150.00 if you already have a UserID and Password but just need it set up.  We will send you an invoice which you can pay by check, bank draft or credit card.

After making your payment, please complete the below provider application for expedited CAQH services.  You will need to complete our provider application (which can be downloaded below) as part of the process.  You can then email it to Andrew Eriksen at caqh@drcred.com.  You may also email us your CV to get started, but we will still need the rest of the information once we begin work on your application.

1.  Complete our Provider expedited CAQH Application.

2.  Complete the form below and upload your document using the upload file option.  You can also email the file, fax it, or send it via snail mail.  We prefer the form if at all possible.  Let us know if you have any problems with the process by emailing us below.  We are a Better Business Bureau accredited organization based in Jacksonville, Florida.  Our fax number is 877-406-4796 and our mailing address for your packet is:

Physician Practice Specialists
ATTN: CAQH
PO Box 350096
Jacksonville, Florida 32235-0096

What is CAQH?

CAQH stands for “The Council for Affordable Quality Healthcare, Inc.”, a not-for-profit collaborative alliance of the nation’s leading health plans and networks.

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 medical credentialing process is a tedious one. With so many different insurance companies to choose from and so many application processes to go through, just being able to accept the insurance company of your patients can be a painstaking process!

Part of the CAQH’s credentialing database project is the new “Universal Credentialing DataSource.” This online database collects all provider information necessary for credentialing and pulls it together into one database, which is then accessible to the different insurance carriers.

Why is CAQH important?

The objective is to only fill out your credentialing information one time through this universal application and eliminate the need to fill out applications for each individual insurance company.

Many insurance companies are now requiring providers to have a CAQH application on file before they will allow them to be credentialed or re-credentialed.

Although the CAQH does not charge for credentialing, the application & process is very time-consuming and can be confusing to the average person.

Our team has completed over 1000 CAQH applications and is intimately familiar with the process.