CAQH

[Jennifer]

Hello! I was curious to see how many organizations utilize CAQH with third party payers.
If you do, does your organization have a contract with CAQH to use proview?
Or, do you make the individual accounts on behalf of the providers?

[Jodi Christopher]

Hi, our payer enrollment specialist sets up individual accounts.

[Susan Hanson]

I set an administrative one for myself and one for each of our providers.

[Wendy Thiebault]

Good afternoon,
We use CAQH at Cuyuna Regional Medical Center. I don’t believe we have a contract with Proview as I think it is free for the providers. I set up the accounts for the providers. I really like CAQH because I just email the insurance and give them the CAQH number of the provider and ask them to look at the application on line to credential the providers. So far Humana, MultiPlan, Aetna, BCBS Minnesota, United HealthCare and Health Net Federal Services/Tricare that I am aware of use this site.

[Keri Pruette]

Hi Jennifer,

We began using CAQH about a year ago. I manage the provider’s accounts for them. I found that most of our provider’s already had accounts. Many of them were not aware that they had an account as it had been set up by someone else several years prior. I found their CAQH Provider ID by logging onto my hospital CAQH account and searching for providers under “manage list”.

Since the provider’s did not know their username & password and we could not create new accounts for them, I contacted CAQH to determine how to access their existing accounts. CAQH emailed me their form, Authorization and Release of Information to Designated Contacts (https://connect.chcnetwork.org/Portals/9/CAQH_Auth__Release_20180726.pdf). I then had each provider complete and sign the form and emailed it to [email protected]. I made sure to include my email address in the contact information field.

Shortly after receiving the forms and verifying the provider’s signature matches that on file, CAQH emailed back confirming that I’ve been listed as an authorized person in each provider’s account. I was then instructed to call the CAQH ProView Helpdesk for account authentication. Upon calling, I’m asked for certain information about the provider – SSN, License#, etc. It can be challenging at times, particularly for provider’s who’ve worked in many states as there is no way to know which “primary license” was listed on the account. That is the hardest step, once complete, CAQH provides you w/the provider’s username, resets the password, & changes the provider’s primary method of contact to your email. From there, you are able to manage the provider’s account.

-Keri Pruette

[Stefanie Frank]

Wow, I’m surprised at the number of people who use CAQH. Great info! I do not currently use it. For the few providers that I had to use it for, I found it very annoying to go in and do their quarterly updates! So far, I’ve been able to send paper apps for those national plans that ask for CAQH.

[Samantha Sherwin]

Hi,

We use CAQH. We set up individual accounts for the provider. We do have an manager account that we use to share the regular information (for example practice locations) to the new provider accounts we set up. It helps with the annoying task of adding the usual information.

I do find it annoying that it has to be updated/reattested every 90 days however we do receive the notice emails and find time to login and reattest. If we stay on top of the reattestations it is simple to login and only have to click the attest button and you are done.

[Author]

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