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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All systems are secured to ensure that only authorized providers and health care organizations can access appropriate data. The system is designed applucation allow you to complete the application over time. How will my information be sent to various health plans? Providers can, at any time, print their CAQH application and send it to non-participating organizations. The notice section of your agreement with each of the participating health plans typically requires you to communicate certain changes to your personal information immediately.
Aplpication involves a tremendous amount of applicagion and administrative time. 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.
The costs associated with the design and development of the database and data collection process have been funded by CAQH through membership fees. 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.
Virus detection mechanisms are used to ensure that the database and the websites are free of all viruses. 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 cah issues impacting their ability to provide care and other background information.
In addition it is important that you notify your Network Coordinator if you’ve made changes to any of zpplication following: In addition, CAQH will comply with any applicable laws and regulations pertaining to confidentiality and security in the development applicqtion the database and the data collection process.
The CAQH Universal Provider Datasource will greatly reduce the amount of administrative time required in this process for physicians and other health care providers. To access the database, interested organizations should contact CAQH for more information about pricing.
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. Who do I contact for administrative support questions when utilizing the database? Do I need to complete the entire application? There is no cost for physicians and other health care providers to use the credentialing application database. With CAQH, a physician or healthcare provider only needs to update information that has changed.
Please be aware, however, that only plans that participate in the CAQH Universal Provider Datasource and that have been authorized by you to access your information will receive any changes.
The main purpose of the pre-population process is to facilitate the use of the application for providers by pre-filling as many data fields as possible with available information. Saves money Medical practices often spend thousands of dollars to buy specialized software, hire consultants or even employ full-time staff to manage the administrative burden of reporting provider data.
Council for Affordable Quality Healthcare
This will help applocation ensure that you continue to conform to the requirements of each participating health plan with which you contract. The password may be changed at any time by accessing the online application website and following the listed instructions. 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.
Health plans and other health care organizations participating in the initiative pay a set administrative fee and set fees per provider to access applicatoon database. It is limited to engineers and monitoring staff. Medical practices often spend thousands of dollars to buy specialized software, hire consultants or even employ full-time staff to manage the administrative burden of reporting provider data.
The Council for Affordable Quality Healthcare CAQH Universal Provider Datasource is designed to accomplish administrative simplification by gathering credentialing data in a single repository that may be accessed by participating health plans and other health care organizations.
Can I use the CAQH database to report any changes to my practice, such as address, phone numbers, and new associates? The entire application must be completed prior to your verification of its accuracy, and before the participating health plans that you have authorized can access it.
Can any health plan access my data? If one of the health plans with which you work is not currently participating in the initiative, please ask them to visit the CAQH website at www.
Its objective is to simplify the credentialing data gathering process applicwtion enable physicians and other health care providers to easily update their information.
Frequently Asked Questions About CAQH | AmeriHealth Caritas VIP Care
When completing the application, you will indicate which participating health plans and health care organizations will be authorized to access your application data. Who is paying for the database and how much does it cost? If the pre-populated data is incorrect, will I be able to override and correct it online?
Filling out multiple forms can take hours, especially when a practice contracts with multiple health plans. All providers interested in participating in our network are asked to complete and return a credentialing application kit. During the initial registration process, providers will create a unique system ID number and confidential password.
Why do I need to review and attest to my information four times a year? 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.
You can transmit the completed application electronically, or you can call the CAQH Help Desk at to request an application be sent by mail to complete the application off-line and then submit it via fax. Only password or PIN-authenticated users have access to their restricted data over connections that automatically encode all information exchanges.