Credentialing Services

How to Complete Your CAQH Profile

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Credentialing is a key step in working with insurance companies and maintaining a smooth and beneficial relationship. However, credentialing can also be time-consuming for your providers and take away from providing patient care. One of the best ways to go about credentialing is by partnering with healthcare contracting experts who can maintain your provider credentials and ensure you don't have to worry about them. So you can see how PayrHealth can help your providers save time and resources, here's a quick guide to completing your CAQH profile and how getting it done quickly and accurately can save your practice time and money.

What is a CAQH Profile? Why Does It Matter?

The Council for Affordable Quality Healthcare (CAQH) is a non-profit organization that was founded by health insurance organizations to unify healthcare administration. It essentially functions as a giant database where healthcare providers and insurance companies can collaborate and access credentials. Virtually every health plan, hospital, or healthcare organization requires completing a CAQH profile when submitting applications. Keep in mind that CAQH does not submit applications to insurance companies or complete the process, but rather plays a vital role in recredentialing and maintaining accuracy in your licenses, policies, and certificates.

What Happens If You Miss Recredentialing?

Unfortunately, providers need to recredential as often as every three months. Although it's not difficult, it can be annoying and time-consuming. However, missing this deadline can create significant problems for your providers and practice. For one, you can miss important reimbursements and be unable to see patients while your information is revalidated, costing significant time and money. For this reason, healthcare contractors like PayrHealth offer credentialing services to remove this responsibility from your practice, ensuring it's done on time.

Connect With Our Team of Experts

Payrhealth is a full-service payor-provider relationship manager. We see a future where providers and payors can make more informed decisions together to build a strengthened healthcare system. Learn more through a free consultation with our world-class experts today.

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How to Complete Your CAQH Profile

Completing your CAQH profile can be frustrating, but our team is here to help. With decades of healthcare industry experience, we can take over your recredentialing process and let your practice focus on what matters.

Get Your CAQH Number

To begin, you'll get a CAQH number from an insurance company with which you're trying to credential. You'll receive a letter with your CAQH provider ID number - you can also do this by self-registering with CAQH. You'll receive your number in an email directly from CAQH. Make sure to keep this number somewhere easily accessible since you'll need it to recredential later on.

Gather Your Materials and Information

Completing your CAQH profile can take a long time, but fortunately, you're not required to do it all at once. However, it's best to have all the required information organized and in one place so you can easily access it when needed. Here's a quick checklist of things to have on hand when you get ready to complete your profile:

  • Basic personal information
  • Education and training
  • Board certification and specialties
  • Practice information
  • Malpractice insurance information (including disclosures and history)
  • Work history and references
  • Resume and/or CV
  • W-9s
  • State licenses
  • ID numbers
  • DEA certificate
  • CDS certificate

It's best to comb through all your materials and make sure everything is formatted according to requirements - doing this before beginning your CAQH profile can ensure you don't have to do it again. We recommend having scanned copies in a secure location so they can be easily uploaded.

Complete Your Profile

We strongly recommend completing your profile online since the paper application can take even longer. As you go along, make sure to save your information by clicking the "next" button - you can come back to work on it later, avoiding doing it all in one sitting. Once completed, make sure to double-check all of the information, since mistakes can significantly hamper the process.

After you complete your profile, you'll choose which insurance companies can access it. You can do this manually based on the insurance companies you work with or by simply allowing any insurance company to access it if they would like to have you on their panel. Regardless of which insurance companies you're applying for, you'll have to re-attest this information every three months, so make sure to keep all your information in a single, easily accessible (and secure) place.

Credentialing Services with PayrHealth

At PayrHealth, we offer professional credentialing services so your providers never miss the deadline. Our team can help your practice focus on providing exceptional care and worry less about managing insurance companies. Get in touch with us today to learn more about how we can help.

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Ready to Begin?

If you're interested in CAQH enrollment help the first step is to contact us online today. Start the conversation with us today to find out how we can be your long-term partner for sustained, robust growth.

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