Article

TennCare & MedCost Now Using CAQH

TennCare and MedCost have adopted CAQH for credentialing and recredentialing — a welcome step, and part of a slow but steady move by more plans toward the shared CAQH database.

By Provider Enrollment Services · Published · Updated · 2 min read

TennCare (Tennessee’s Medicaid program) and MedCost, a North Carolina insurance company, now use CAQH to support more timely credentialing and recredentialing. For providers, that is good news: a plan drawing from the shared CAQH database is generally faster and less repetitive to work with than one running its own separate paperwork.

Why this matters

Both plans had struggled to keep up with their own recredentialing requirements, and moving to CAQH is a practical fix. The more payers that rely on the shared CAQH profile, the less duplicate paperwork providers have to complete — you maintain one accurate profile instead of feeding the same information into many separate systems.

TennCare is not the first state Medicaid program to adopt CAQH, and it likely will not be the last. Several other state Medicaid programs have used CAQH for their credentialing as well. Each plan that joins makes commercial and Medicaid credentialing a little more consistent for everyone.

There are still holdouts running older, slower credentialing methods, and we would welcome more of them making the same move.

The takeaway

If you keep your CAQH profile complete and attested, you are already positioned to work smoothly with the growing list of plans that pull from it — including newer adopters like TennCare and MedCost.

Provider Enrollment Services sets up and maintains CAQH profiles as part of credentialing, in-house since 2008. Explore our CAQH credentialing services, read CAQH credentialing made easy, or request a quote at (800) 406-4796.

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Provider Enrollment Services is a credentialing and payer-enrollment service; approval decisions and timelines are determined by the payers and CMS, not PES.