What is CAQH? What their process?

What is CAQH?

The Council for Affordable Quality Healthcare® (CAQH) is a not-for-profit collaborative alliance of the nation's leading health plans and networks. CAQH's mission is the improvement of healthcare access and quality for patients and the reduction of the administrative burden for healthcare providers and their office staff.

Faxing Guidelines

1. Fax your documents ONLY to 1-866-293-0414 (toll-free).
2. Office Managers: Send one provider at a time, each with their corresponding fax cover sheet.
3. Place all pages in the correct order, facing the same direction.
4. Complete all information on the fax cover sheet:
Mark the documents you included and the number of pages for each.
5. Make sure your fax machine is set to the highest resolution: typically, "High" or "Fine" mode.
To ensure legibility, please make a readable photocopy of the DEA Certificate prior to
6. Ensure that your fax machine indicates a successful status code. If not, refax all documents.

Avoid These Common Mistakes

1. Cover sheet problems
2. Faxing your documents more than once
3. Faxing your data summary
Do not fax this page with your documents. This is for information only.

CAQH uses special technology to identify you and your documents based upon the personalized fax cover sheet that is printed from the Universal Credentialing DataSource. If this document is not used properly, your processing time may be delayed, or we may not be able to identify you at all.

The most common errors are:

These above errors represent approximately 60% of all faxing problems. Careful attention to the
cover sheet when faxing your documents is extremely important.

All supporting documents are manually reviewed for clarity, orientation and appropriate provider
association. At a minimum, this process will take at least 24 hours; sometimes up to 3-4 days,
depending on volume. DO NOT re-fax your documents if they do not immediately appear for viewing in the Universal Credentialing DataSource. It will not speed up the process.

The Universal Credentialing DataSource allows you to print and review the information you have
entered into your application via a "Data Summary." DO NOT send this data summary with your
supporting documents.

1 comment:

provider enrollment said...

The CAQH record is a major advancement in the credentialing process. Most major insurance companies require it as part of their procedures. Filling it out for the first time can be quite daunting however and requires a good deal of record collecting in advance. I helps to review all the information that it require and collecting that information before you begin to fill out the form. It saves a great deal of time and limits the frustration.

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