CAQH Credentialing

group_of_cliniciansWhat is CAQH?

CAQH is an online data repository of credentialing data.  Practitioners self report demographic, education and training, work history, malpractice history, and other relevant credentialing information for insurance companies to access.  Electronic access to this information is meant to reduce the burden of paperwork by eliminating much of the paper based enrollment process involved with payor network enrollment and facility privilege applications.

From their website “CAQH is 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 the improvement of healthcare access and quality for patients and the reduction of the administrative requirements for physicians and other health care providers and their office staff members”

The ultimate objective of The Council for Affordable Quality Healthcare is to gather credentialing information on healthcare practitioners and make that information available to health plans and other healthcare entities in order to streamline the credentialing process.

How Do I Participate with CAQH?

In order to create an online profile for healthcare entities to access your information, you need a CAQH ID and username and password for the website.  With new CAQH Proview, you can obtain a CAQH ID directly from the website.

How can nCred Help Me?

We can help you obtain your CAQH ID and completing your online profile.  Creation and maintenance of your CAQH profile is included in our credentialing file maintenance plan.  We’ll maintain your profile so that insurance networks participating with CAQH will always have access to current credentialing information.

Having a complete CAQH profile is an important step in commercial insurance credentialing, however, there are other tasks to be performed to complete your credentialing and contracting with payors who participate with CAQH.  There is a common misconception that the only thing a provider needs to do is complete CAQH and it will automatically enroll them with all the health plans.  CAQH is just one tool that you will use for provider enrollment with health plans.

Beyond CAQH Profile Creation

Once you’ve completed your CAQH credentialing profile, you’ll need to maintain it by attesting to information accuracy on a quarterly basis and updating supporting documents within the CAQH system.  The insurance enrollment process will also include some level of processing information forms in addition to sharing your CAQH profile with health plans.

nCred can assist you with ongoing maintenance of your profile as well as assisting you with payor network and facility privilege applications.

Features and Benefits of working with nCred

  • Knowledge of completing and maintaining your CAQH profile
  • Quick turnaround time of your CAQH profile
  • Ongoing maintenance including re-attestation and documents submission
  • You and your medical office staff can focus on more important patient matters than dealing with enrollment paperwork

Visit our Enrollment Information page for details of all our service plan options.

nCred is not CAQH.  nCred is a credentialing service that assists healthcare providers with obtaining a CAQH ID and completing, updating, and maintaining your CAQH profile to assist with insurance credentialing, contracting, and enrollment.  Our services are provided for a fee.  Our services are not required in order for your to obtain a CAQH ID, but offer you time saved by completing the process on your behalf.  If you need to contact CAQH for your login information or to obtain your ID, then contact them directly using the information from the CAQH website.