CAQH Credentialing

What is CAQH?

CAQH is an online data repository of credentialing data.  Practitioners self report demographic, education and training, work history, malpracticie history, and other relevant credentialing information for insurance companies to access.  Electronic access to this information is meant to reduce the burden of paperwork by eliminating much of the paper based enrollment process involved with payor network enrollment and facility privilege applications.

From the CAQH website "CAQH is The Council for Affordable Quality Healthcare, Inc., a not-for-profit collaborative alliance of the nation’s leading health plans and networks. The mission of CAQH is the improvement of healthcare access and quality for patients and the reduction of the administrative requirements for physicians and other health care providers and their office staff members"

The ultimate objective of CAQH is to gather credentialing information on healthcare practitioners and make that information available to health plans and other healthcare entities in order to streamline the credentialing process.

How Do I Participate with CAQH?

In order to create a CAQH profile for healthcare entities to access your information, you need a CAQH ID and username and password for the website.  CAQH ID's are issued by participating health plans.  CAQH itself does not issue ID's.  In order to obtain a new ID, you must contact a participating organization and request to be put on their roster and be given a CAQH ID.  The health plan determines whether or not they will issue a CAQH ID to a practitioner based on their network needs and credentialing criteria.

The process of obtaining a CAQH ID can be confusing and time consuming.  nCred can assist you with obtaining the ID and completing your profile.  We can also maintain your profile keeping your documents up to date.

How can nCred Help Me?

We can help you by obtaining your CAQH ID and completing your profile.  We offer several service packages to assist healthcare practitioners with credentialing needs.  Our All-Inclusive Service Subscription includes creation and maintenance of your CAQH profile, or you can purchase enrollment applications individually including CAQH. 

If you would like assistance with creating your CAQH profile, our CAQH profile service is $200 per practitioner.  We will turn around your CAQH profile within 7 working days of receiving your completed nCred application and supporting documents.
 

Beyond CAQH Profile Creation   

Once you've completed your CAQH profile, you'll need to maintain your profile by attesting to information accuracy on a quarterly basis and updating supporting documents within the CAQH system.  The insurance enrollment process will also include some level of processing information forms in addition to sharing your CAQH profile with health plans.

nCred can assist you with ongoing maintenance of your CAQH profile as well as assisting you with payor network and facility privilege applications.   

Features and Benefits of working with nCred

• Experienced credentialing professionals with extensive experience in enrollment with Medicare, Medicaid, and commercial insurance networks
• Knowledge of completing and maintaining your CAQH profile
• Quick turnround time of your insurance network enrollment applications
• Track the status of your enrollment applications through our secure website
• You and your medical office staff can focus on more important patient matters than dealing with enrollment paperwork

SERVICE PLANS

All-Inclusive Practitioner Credentialing Subscription

Our all-inclusive credentialing service provides you with a complete outsourced credentialing office to handle all your needs.  With our annual subscription, you get dedicated credentialing staff that will take care of any credentialing matter that may arise including submission of insurance network enrollment applications, hospital privilege applications, managing all your credentialing data and documents, maintaining your CAQH credentialing file, keeping your documents up to date with CAQH, insurance carriers, and facilities, and being the primary point of contact for any credentialing matters that may arise in your office. Our all-inclusive service includes:

• Online application and document upload allows you to complete our credentialing application and send us copies of documents online to provide us with all the information that we'll need to complete your insurance network enrollment applications
• Complete insurance network enrollment applications on your behalf
• Complete re-enrollment (re-verification) applications from insurance networks on your behalf
• Complete hospital privilege applications and re-appointment applications on your behalf
• Track and verify receipt of your applications and follow-up until the applications are processed
• Maintain your credentialing file and all of your date sensitive documents such as licenses, malpractice insurance, etc.
• Store copies of all your documents on our server
• Maintain your record of CME's and proof of attendance
• Maintain your CAQH profile and handle quarterly attestations
• Maintain your NPI record and make any updates needed
• Serve as the primary point of contact for your practice for any credentialing issues with insurance companies and hospitals
• Access to your credentialing file and document copies in our system through our secure internet portal
• Credentialing staff with extensive experience in working with Medicare, Medicaid, and commercial insurance enrollment

All these benefits for one low monthly service fee allows you to easily budget and know what your expenses will be regardless of the number of insurance network enrollment applications that you need processed.

Basic Payor Enrollment Subscription

Our basic subscription plan provides you with payor enrollment services and maintenance of your credentialing file.  With our basic plan, we manage your credentialing data and document copies for an entire year so that we can process your insurance network enrollment applications as you need them throughout the year long subscription period.  Our basic subscription will provide you with enough insurance network enrollment applications to enroll with the primary carriers in your area.

The Basic Subscription Includes

• Complete your CAQH credentialing profile and process up to nine payor enrollment applications for a total of 10 applications  
• Maintain your credentialing file in our secure database with electronic copies of all your credentialing documents.
• Maintain your CAQH profile to ensure that insurance networks have access to your current credentialing information
• Provide you with real-time, secure access to your credentialing file through our web portal.  You can view, download, and print any document attached to your credentialing file.
• Renew your subscription for a low annual rate to manage your credentialing file

Enrollment application processing

If you just need assistance with an application or two, we can help with that as well.  With our enrollment application processing service, you simply tell us what insurance companies that you want to enroll with and we’ll populate the forms, submit them to the carriers and follow-up until the application is processed.  This service includes:

• Access to our online information center to provide us with all the information we need to complete your enrollment applications, including uploading documents such as licenses, certifications, insurance, etc.
• Complete your enrollment forms and submit to the carrier along with other documents required
• Follow up with the carrier until your application is processed
• Credentialing staff with extensive experience in working with Medicare, Medicaid, and commercial insurance enrollment
• Volume discounts available when purchasing more than 1 application

Order your CAQH Profile
Our CAQH profile processing is a flat fee of $200.  Get started right now by clicking the button below

    Call us today at
(423) 443-4525 if you have questions or need additional information. 

 

Contact CAQH

Website:
General Information
http://www.caqh.org

Universal Provider Datasource (CAQH Login)
https://upd.caqh.org/OAS/

CAQH Provider Help Desk:
888-599-1771
caqh.updhelp@acsgs.com

Help Desk Hours:
7am-9pm EST Monday - Thursday
7am-7pm EST Friday