CAQH Attestation & Maintenance
What is CAQH?
CAQH (Council for Affordable Quality Healthcare) Provider
Data Portal formerly known as CAQH ProView is a non-profit platform that facilitates to store all the information that is essentially needed for provider credentialing with all leading health plans and network IPA groups.
CAQH Provider Data Portal eliminates duplicative paperwork for organizations that may require
provider profile information for claims administration, credentialing, directory services, and more.
The act of acknowledging and approving a provider’s CAQH application is called CAQH attestation.
Attesting to the CAQH profile means acknowledging that all the provider’s information on the portal is accurate and updated. It is a continuous process that needs the portal review and attestation every 120 days as a standard rule set; there shall be automated notifications from CAQH that shall serve as reminders on any renewals needed with licenses, malpractice, and other details.
CAQH Provider profile can be accessed from anywhere and anytime, it’s important to keep the provider’s profile is current and there has been a process set by CAQH to make it a practice by insisting providers review and attest their profile every 120 days; such a rule set can ensure providers have all the details up-to-date on the CAQH portal which is regularly accessed by health plans and other organizations for credentialing, re-credentialing and contracting purposes.
Importance of timely CAQH Attestation
Failure of timely attestations to the CAQH profile can possibly cause denials or rejections on claims and possibly terminate the existing contracts with Insurance during the re-credentialing process of the health plans which are usually between 1 and 5 years as per the health plan’s norms.
Our team’s role in CAQH Attestation & Maintenance
Our team focuses on all the areas that have an impact on the RCM process of a provider’s practice. We do directly handle these services starting from CAQH set-up or registration to regular attestation and maintenance. We have the needful expertise and skillset to handle this process.