CAQH credentialing: how to set up, authorize and attest your profile

What CAQH is and why insurers use it

CAQH ProView is a shared database of provider information. Instead of filling in a long application for every insurer, you enter your details once in CAQH and each insurer you authorize pulls them from there. Most commercial insurers, Medicare Advantage plans and Medicaid managed care plans use it, which is why the first thing many of them ask for is your CAQH ID.

It's free for providers. The insurers pay CAQH for access.

Two things CAQH is not:

• It isn't an application. A complete CAQH profile doesn't put you in any network. You still apply to each insurer, and each one still decides whether to accept you. See how to get credentialed with insurance companies for the whole process.
• Medicare doesn't use it. Traditional Medicare enrollment runs through PECOS, a separate federal system. See our Medicare enrollment guide.

What to have ready

Plan on about two hours for the first session if your documents are at hand. You can save and come back.

• NPI and Tax ID
• State license numbers and expiration dates
• DEA and state controlled-substance registrations
• Board certification details
• Education and training: names, addresses, dates
• Work history since training, month and year
• Malpractice policy: carrier, policy number, limits, dates
• Hospital affiliations or admitting arrangements
• Practice locations, phone, hours
• Professional references, usually three

Setting up your profile, step by step

Step 1: Get your CAQH Provider ID

There are two ways in. Often an insurer or your practice starts the registration for you, and CAQH emails you a Provider ID and a link to finish setting up your account. If nobody has done that, you can register yourself on the CAQH ProView provider portal using your NPI. Either way, you end up with a CAQH Provider ID, which you'll give to every insurer you apply to.

Step 2: Complete every section

The profile walks you through each section in order. Most delays come from a handful of them:

Step 3: Upload your documents

Upload current copies of your license, DEA, board certificate, malpractice certificate (the face sheet showing dates and limits), CV and W-9. Insurers read the expiration dates. An expired document is the most common reason a profile that was fine last year now holds up an application.

Step 4: Authorize the insurers

This is the step people miss most. An insurer can't see your profile until you give it permission, even if your profile is complete and attested. You can authorize every participating plan at once or choose specific ones. If you choose specific plans, add each new insurer before you apply to it.

Step 5: Attest

Attesting is your confirmation that everything in the profile is true and current. Insurers only rely on a profile with a recent attestation. Once you attest, the profile is ready for insurers to use.

Keeping your CAQH profile current

If your attestation lapses, insurers treat the profile as out of date. New applications stall and re-credentialing can't finish, which can put your network status at risk. For example, UnitedHealthcare says that if you keep a complete, current attestation every 120 days, its re-credentialing needs nothing more from you. See our UnitedHealthcare credentialing guide.

Common CAQH problems and fixes

• "We can't see your profile." Authorize that insurer, then re-attest.
• Application on hold for missing information. Look for a red or incomplete section, often work history gaps or disclosure explanations.
• Expired documents. Upload the current version and re-attest so insurers pull the new data.
• Locked out or lost your ID. Use the ProView login recovery, or ask the insurer that invited you for your CAQH ID.
• Two profiles. Providers who registered twice can end up with duplicate IDs. Contact CAQH support so insurers read the right one.

Where CAQH fits in credentialing

CAQH is step two of six. After it's attested and authorized, you apply to each insurer, such as your state's Blue Cross Blue Shield plan and UnitedHealthcare, and enroll in Medicare and Medicaid separately. Our step-by-step credentialing guide covers the full order.

Common questions