CAQH credentialing is the process of setting up and maintaining your CAQH ProView profile — the shared online record that commercial insurance companies pull from when they credential you. Nearly every provider seeking commercial panels needs a CAQH ID and a complete, attested profile, and getting it right up front keeps your credentialing from stalling later.
What CAQH is and why you need it
CAQH ProView is a central database that commercial payers — BCBS, Aetna, UnitedHealthcare, Cigna, and others — use as a credentialing repository. Rather than sending the same documents to every payer, you maintain one profile, and the payers pull the information they need from it. Because so many carriers rely on it, having a complete CAQH profile is effectively a prerequisite for commercial credentialing.
The steps that trip people up
Setting up a CAQH profile is tedious the first time through, and two easy-to-miss steps quietly hold up credentialing:
- Attestation — you must attest that your profile is accurate, and re-attest on CAQH’s recurring cycle (roughly every 120 days). [Relias, Verisys] A lapsed attestation can freeze credentialing at the payer.
- Authorization — you have to authorize the insurance companies to access your profile. Payers cannot pull what you have not shared.
Keeping documents current in the profile — licenses, malpractice coverage, work history — also matters, because payers verify against what is stored there.
Making it easier
The value of help here is not a shortcut through CAQH’s steps — it is having someone who has done it many times set up your profile correctly, attest and authorize it properly, and keep it current so credentialing does not stall on a missed attestation.
Provider Enrollment Services sets up and maintains CAQH profiles as part of credentialing, in-house and US-based, since 2008. Explore our CAQH credentialing and profile management services, find out whether Medicare uses CAQH, or request a quote and talk with a specialist at (800) 406-4796.