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May 2018

Here’s what you need to know about CAQH ProView

To ensure your CAQH ProViewTM credentialing and recredentialing applications are processed efficiently, follow the guidelines below.

Retirement status

  • When answering the question “Are you retired” on your application, you should only select “Yes” if you have completely retired from providing medical or behavioral health services to members. Answering “Yes” signifies that you’re retired from practicing.
  • If you move to a new location, practice group or physician organization, you should include this information in your demographic responses on ProView where indicated. Don’t answer “Yes” to indicate you’ve retired from a location, practice, etc.

Health plan authorization

As previously shared, Blue Cross Blue Shield of Michigan utilizes CAQH to obtain credentialing verifications for physicians during recredentialing cycles. To avoid delays, you must list Blue Cross as one of the health plans authorized to obtain and receive your information from CAQH.

Update your practice information

Review the demographic information for your practices this quarter to ensure its up to date. Pay close attention to the following:

  • If you’re an individual practitioner, review all your practice locations and ensure they’re updated in CAQH Proview, including address, suite numbers and phone numbers.

  • If you’re a practice group, ensure all your practice locations are updated, including suite numbers and phone numbers, through the Provider Self-Service tool.

  • Locations and providers that don’t see patients for appointments should be suppressed so they’re not visible to members in the online directory. Emergency room physicians and administrative addresses are examples of information that shouldn’t be displayed in the directory.

For more information

Here are some resources for providers and their practice managers:

  • For help with CAQH ProView, go to caqh.org/solutions/caqh-proview or call CAQH at 1-888-599-1771.
  • For help with the Provider Self-Service tool, go to bcbsm.com/providers. To sign up for self-service, follow these steps:
    • Click on the Join Our Network tab and then Enrollment and Changes.
    • Click on self-service FAQ.
    • Click on How do I sign up?

You can also call Provider Enrollment at 1-800-822-2761.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.