We use the Council for Affordable Quality Healthcare®, or CAQH, to gather and coordinate our practitioner credentialing information. This process helps streamline paperwork for providers and their office staff.
If you’re ready to begin credentialing, you’ll need to enroll with us first. As you enroll, we’ll ask you a few questions and give you the forms you’ll need.
We’ll pass your information along to CAQH and they’ll send you a registration kit. The kit will have your ID to access the CAQH Universal Provider Datasource® database online. Then you can submit your application electronically.
Find out more about the process at CAQH.org or by calling 1-888-599-1771. Or you can read more in our CAQH FAQ (PDF).
Credentialing and recredentialing tips
Here are some guidelines to help make the credentialing and recredentialing process go faster:
- Reattest every 120 days and keep your CAQH information current.
- Maintain your current board specialty and certification status on CAQH.
- Be careful when choosing your primary specialty on CAQH because your primary specialty choice:
- Determines whether you’re designated as a primary care physician or specialist for managed care networks
- May affect the way claims are processed and paid
- Will be shown in our online provider directories
- Give CAQH your current malpractice insurance face sheet.
- Ask your malpractice insurance carrier to submit your liability insurance information on time. Send the Professional Liability Verification Form (PDF) and the Authorization for Release of Information Form (PDF) to your current insurance carriers. Please note that the Professional Liability Verification form needs to be completed by your carrier and faxed to the number on the form.
- If you’re practicing exclusively in an inpatient hospital setting, be sure to update CAQH with that information. It’s used to determine if full credentialing is needed.
- If you’re a new graduate, wait until 60 days before you finish your training to submit your application.
- If you’re relocating from out of state, you can submit your application 30 days before your start date.
- Be sure you’ve signed and included all your enrollment signature documents before you fax them.
Checking the status of your application
If you want to check on an application that’s in progress, contact the Provider Enrollment and Data Management department at 1-800-822-2761.
When you call, please have these three items available for each provider:
- National Provider Identifier number.
- Group tax ID number or last four digits of the individual provider’s Social Security number.
- Primary address and phone number.