CAQH Registration

What is a CAQH ID?

In simple terms, The Council for Affordable Quality Healthcare, Inc (CAQH) is an online data repository that stores provider information. Providers, in turn, grant access to these details to insurance companies. It makes the process of acquiring information for the payer much easier as all they have to do is pull up a provider’s profile rather than calling your office to get copies of medical licenses and information about work history.

Practitioners who want to take advantage of CAQH first need to obtain a CAQH provider login then enter details about their training and education, demographics, work history, malpractice history and any appropriate credentialing details for insurance companies to access. The login process is detailed below under Step-by-Step CAQH Registration process. 

The primary aim of CAQH is to enhance health care access and by reducing the administrative challenges for healthcare providers, physicians, and office staff members. It comes in handy since it helps to save time, especially when compared with the traditional paper application submissions.  Once you register with CAQH, you are supplied with a CAQH ID number which is what you will supply to the payers during the credentialing process.

Materials Needed for CAQH Registration:

There are several supporting documents you need to register with CAQH such as:

  • DEA (Drug Enforcement Administration certificate)
  • W9
  • CDS (Controlled and Dangerous Substances) certificate
  • Multiple identification numbers such as Medicaid, NPI, Medicare, etc
  • State medical licenses
  • Malpractice insurance certificate
  • Board Certification Certificate
  • CV

Step-by-Step CAQH Registration Process

The registration process takes a few steps to complete which we’ve outlined below:

  1. To obtain a CAQH provider number, a physician must start by credentialing with a particular health care firm. The organization will request the applicant’s participation in the universal provider data source that CAQH registration provides. All participating agencies can be seen on CAQH’s official website.  This has changed slightly in recent years with the introduction of CAQH Proview.  You can now obtain a CAQH ID without initiating the process with the insurance payer.  For more information on this process, check out our recent article on the CAQH registration process and why it’s important to your practice linked below.
  2. As soon as you begin the credentialing process with your preferred organization, you will get the ID number in your mail. Do not lose the number as you will use it to log into the CAQH site where you will go ahead and submit your details.
  3. After getting the provider number, you are allowed to log in and register. Once you are on the site, take note to follow the instructions keenly, and you will complete all the details with no problem. Remember that there is no pressure and it is not mandatory that you fill out all the details at once. However, do n’t forget to save the information that you have already filled out so that you can take it up from there when it is time to continue. It is a simple process since when you click on “next” to move on to the other page the web site automatically saves all the details you have filled in from the first page.
  4. After filling in all your details, the website requests that you conduct an information audit that ascertains everything is in order.
  5. The last step is to “attest” all your details (the site instructs you to do it). If the file is complete, you will get a message saying so and only then will you be done with CAQH registration.

Remember to save your password and the username somewhere safe because you will be required to use the details to log into the website in the future that you can keep the information up to date. It is the only way to maintain your CAQH profile because the site requires members to attest their information on a quarterly basis as they update the supporting documents in the system.

Features Of CAQH

CAQH UPD (Universal provider data source) is a service that seeks to establish the standards for physician credentialing. When a physician goes through with CAQH registration, they can access various essential functions like:

  • Suggested and required fixes ascertain a comprehensive portfolio before attesting to the information
  • Drop down selections that make it easy to select sections and fields, e.g. hospitals, medical schools, etc
  • Data validation that helps to prevent errors
  • Autosave features as a person moves from one screen to the next
  • Customer support and round the clock access to the website
  • In-depth FAQ and help section that offers guidance on how a person is supposed to complete all the profile sections.

How Do Physicians Benefit from CAQH?

CAQH helps to eliminate frustration associated with payer credentialing and save time. It stores data electronically which eliminates the need for paper submission. Physicians can control information thanks to the advanced security features (see physician credentialing services for more info). By streamlining the process of data collection electronically, CAQH significantly reduces redundant paperwork being sent to each payer, and it reduce costs when it comes to the administrative burden associated with this process. It benefits millions of health care providers and hundreds of participating hospitals, health plans, and other healthcare organizations.

Worth noting is that physicians and health care providers do not have to pay anything to take advantage of CAQH. It is a time-consuming process but CAQH does not charge anything to providers for access to the system. Payers and healthcare organizations pay for access but the providers do not pay anything. At PPS, we offer a service to take you through this process which can be rolled into our credentialing package or paid for separately.

How to Register with CAQH & Why it Matters to Your Practice

CAQH is ubiquitous in the medical field these days but there are still a lot.... [Read more]

Can you retroactively bill Medicare after credentialing is complete?

Retroactively billing Medicare is an important detail to understand due to how long credentialing can.... [Read more]

How to credential a provider with an insurance company?

We wish it was simple but it's far from it. In this article we identify.... [Read more]

Should my billing company do my payer credentialing?

As you will quickly learn if you’re starting a new practice or evaluating billing companies,.... [Read more]