Most commercial payers do not read your credentials from the application you send them. They pull them from CAQH ProView, the shared profile that holds your licenses, training, work history, malpractice coverage and practice locations. If that profile is incomplete, out of date or not shared with the payer, the application waits, often without anyone telling you why.
Our CAQH credentialing work makes the profile complete and keeps it that way, so every payer application that depends on it can move.
What a complete profile needs
- Licenses and registrations: state license, DEA and state controlled substance registration where they apply.
- Education and training, with dates that match your CV.
- Board certification, or the status of it.
- Work history with no unexplained gaps. A gap of a few months with no explanation is one of the most common reasons an application is held.
- Malpractice insurance, with a current certificate and claims history.
- Hospital affiliations or an admitting arrangement, where the payer requires one.
- Practice locations, tax ID and group NPI, matching what you put on your applications.
- Disclosure questions, answered and explained where needed.
Three things that stall applications
The attestation lapses
CAQH asks every provider to re-attest every 120 days that the profile is still accurate. Miss it and the profile goes inactive, and every payer application that depends on it stops, quietly. We track the date and attest on time.
The payer cannot see the profile
A complete profile is no use if the payer has not been given access. You can authorize all plans or choose them one by one. We check that every payer you are applying to is authorized.
Documents expire
Licenses, DEA registrations and malpractice certificates all expire, and an expired document on file holds an application as surely as a missing one. We update them as they renew.
What CAQH does not cover
CAQH is used by most commercial plans, but not by everyone. Medicare enrollment runs through PECOS, and state Medicaid programs have their own systems. A complete CAQH profile is one part of payer enrollment, not all of it. We handle both.
CAQH FAQs
Does CAQH cost anything for providers?
No. Providers use CAQH ProView for free. What takes time is building the profile correctly and keeping it current.
How do I get a CAQH ID?
Usually a payer you are applying to starts the registration and you receive the ID, or you can register yourself. If you already have one from a previous job, keep it: one provider should have one CAQH profile for life.
Can you take over a profile someone else set up?
Yes. We review what is there, fix what is wrong or out of date, and set up the attestation and document reminders from that point on.
Get your CAQH profile checked
Send us your CAQH ID and the payers you want. We will tell you what is missing before a payer does.
Get a free credentialing check Talk to a credentialing specialist