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Practitioner CAQH® Application Instructions and Checklist. Instructions for New Practitioners Not in the CAQH Database. Complete the Practitioner Data. Code list is found on page Enter the associated 3-digit code in the space provided.*. NOTE: CAQH will use this method for application follow-up. NUMBER . 19 Jul What is the CAQH Universal Credentialing DataSource (UCD)? providers learn more about the CAQH credentialing application database?.

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If the pre-populated data is incorrect, will I be able to override and correct it online? If one of the health plans with which you contract is currently not participating in the initiative, please ask them to visit the CAQH website at www.

The CAQH Universal Provider Datasource will greatly reduce the amount of administrative time required in this process for physicians and other health care providers. Secure internet accesses to application screens, use of passwords, electronic signatures and certificates, and powerful bit Secure Socket Layer SSL encryption are used to ensure only authenticated use of the system. The system is designed to allow you to complete the application over time. All providers interested in participating in our network are asked to complete and return a credentialing application kit.

The main purpose of the pre-population process is to applicatkon the use of the application for providers by pre-filling as many data fields as possible with available information.

How will my information be sent to various health plans?

The Council for Affordable Quality Healthcare (CAQH)

Learn more about our credentialing criteria for professional providers. You will still need to contact any caqn plans directly. All systems are secured to ensure that only authorized providers and health care organizations can access appropriate data. Filling out multiple forms can take hours, especially when a practice contracts with multiple health plans. Please complete the Provider Participation Form.

Can I use this process to submit information to non-participating health plans and to my hospital affiliations? Only health care organizations authorized by a provider have access to provider data, and a provider has access only to his or her own data.

Who is paying for the database, and how much does it cost? One of the most integral parts of the credentialing process is the collection and verification of vital data from the physician regarding his or her education, training, experience, practice history, location, disclosure of any issues impacting their ability to provide care and other background information.

This may be quickly done via online access. Once a provider completes the application, all the information is automatically made available to authorized health plans, hospitals, and other health care organizations with whom you participate. In addition it is important that you notify your Network Coordinator if you’ve made changes to any of the following: The costs associated with the design and development of the database and data collection process have been funded by CAQH through membership fees.

When completing the application, you will indicate which participating health plans and health care organizations will be authorized to access your application data. How can I access applicztion database? The entire application must be completed prior to your verification of its accuracy, and before the participating health plans applicatioon you have authorized can access it.

Council for Affordable Quality Healthcare

The electronic application will present the questions to you in an interview style, with logic that presents the questions that are relevant to your particular specialty or provider type. In addition, CAQH will comply with any applicable laws and regulations pertaining to confidentiality and security in the development of the database and the data collection process. Can I use the CAQH database to report any changes to my practice, such as address, phone numbers, and new associates?

Credentialing involves a tremendous amount of paperwork and administrative time. Can any health plan access my data?

Frequently Asked Questions About CAQH

The CAQH Universal Provider Datasource is designed to be compliant with all laws, rules and regulations relating to the privacy of individually identifiable health information. Who do I contact for administrative support questions when utilizing the database? Access and registration instructions will be sent to physicians and other health care providers as the initiative is launched in your market.

All network traffic to and from the center is routed through redundant firewalls for complete security to the database and online systems. Applicxtion plans and other health care organizations participating in the initiative pay a set administrative fee and set fees per provider to access the database. Applicatjon detection mechanisms are used to ensure that the database and the websites are free of all viruses. Routine tape back-ups protect all volatile system data and are secured in an off-site storage facility.

Providers can, at any time, print their CAQH application and send it to non-participating organizations. ET, to provide assistance with any questions you may have.

With CAQH, a physician or healthcare provider only needs to update information that has changed. This will help to ensure that you continue to conform to the requirements of each participating health plan with which you contract.

Only password or PIN-authenticated users have access to their restricted data over connections that automatically encode all information exchanges.