CAQH Registration

TriumpHealth supports healthcare providers with CAQH (Council for Affordable Quality Healthcare) registration as an extension of our credentialing services
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PROVIDER CREDENTIALING & PAYER ENROLLMENT

What is CAQH?

CAQH (Council for Affordable Quality Healthcare) ProView is an online database for storing provider information such as specialty, DEA, license, education, malpractice, CV, and legal records. It eliminates duplicative paperwork with organizations that require your professional and practice information for claims administration, credentialing, directory services, and more. Most payers require CAQH databases for each of their applicants to effectively access and verify their personal information during the enrollment/contracting process. Due to this requirement, a complete CAQH is necessary to begin the credentialing process.

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What is needed to create a CAQH Profile?

To get your CAQH set-up and complete, you will be asked for:

  • eva arrow up fill 1 Personal Information
  • eva arrow up fill 1 Professional IDs
  • eva arrow up fill 1 Education & Professional Training
  • eva arrow up fill 1 Specialties
  • eva arrow up fill 1 Practice Locations
  • eva arrow up fill 1 Hospital Affiliations
  • eva arrow up fill 1 Credentialing Contacts
  • eva arrow up fill 1 Professional Liability Insurance
  • eva arrow up fill 1 Employment Information
  • eva arrow up fill 1 Professional References
  • eva arrow up fill 1 Disclosure

Let TriumpHealth maintain your CAQH for you!

TriumpHealth not only provides support by creating your CAQH account, but we also help you maintain your existing account by uploading and regular attestation of your most recent documentation. This ensures that you are contracted with the payers and reimbursed for the services you provide as fast as possible. We will guide you along the way, and make sure that all your personal information is stored safely and correctly within the CAQH Proview database. Our skilled credentialing team will build your profile and ensure that it is complete and maintained on a regular basis.

Frequently Asked Questions

What is CAQH registration, and why is it important for healthcare providers participating in insurance networks?

CAQH registration is the process by which healthcare providers create and maintain a profile with the Council for Affordable Quality Healthcare (CAQH), a nonprofit alliance of health plans and trade associations. It is important for providers participating in insurance networks as it centralizes credentialing and reduces administrative burden by allowing payers to access standardized provider information for network participation.

How do you initiate and manage the CAQH registration process for healthcare providers, and what information and documentation are required for successful registration?

We initiate and manage the CAQH registration process by guiding providers through profile creation, completing required forms, and submitting necessary documentation. Information and documentation required for successful registration typically include provider demographics, education, training, licensure, malpractice history, and professional references.

Can you elaborate on the significance of maintaining accurate and up-to-date information within the CAQH profile, and how do you ensure compliance with ongoing CAQH requirements?

Maintaining accurate and up-to-date information within the CAQH profile is crucial for ensuring that payers have access to current provider credentials and qualifications. We ensure compliance with ongoing CAQH requirements by monitoring profile expiration dates, updating information as needed, and conducting regular reviews to verify data accuracy.

How do you stay informed about changes in CAQH requirements and policies, and how does this information influence your approach to CAQH registration services?

We stay informed about changes in CAQH requirements and policies through regular communication with CAQH representatives, monitoring of CAQH website updates, and participation in CAQH training sessions. This information influences our approach to CAQH registration services by ensuring that we adapt quickly to regulatory changes, anticipate updates, and provide up-to-date guidance to healthcare providers throughout the registration process.

Our Process

1

Initial Consultation and Data Collection

Conduct an initial consultation with the healthcare provider to gather necessary information for CAQH registration, including personal details, contact information, professional credentials, and supporting documentation.
Assist the provider in completing any required forms and obtaining relevant documents such as medical licenses, certifications, and malpractice insurance information.

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2

CAQH Registration and Profile Creation

Complete the registration process on the CAQH ProView platform, ensuring accurate entry of personal and professional information.
Assist with uploading and organizing supporting documents within the CAQH ProView portal, such as medical licenses, DEA registration, board certifications, and malpractice insurance.

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3

Document Verification and Submission

Verify the accuracy and completeness of all entered information and uploaded documents before submission.

Review the completed CAQH profile with the provider to ensure alignment with their credentials and qualifications.

Submit the finalized CAQH profile to CAQH for review and approval on behalf of the provider.

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4

Follow-Up and Maintenance

Monitor the progress of the CAQH registration and profile creation process, addressing any requests or inquiries from CAQH as needed.
Provide ongoing support to the provider in maintaining their CAQH profile, including updates to personal and professional information, and uploading new credentials or documents as necessary.

Ensure compliance with CAQH requirements and deadlines, facilitating smooth credentialing and contracting processes with participating healthcare organizations and health plans.

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Benefits of Working with TriumpHealth

CAQH Registration

1

Easy Set-up

Whether you run a small medical practice or a large FQHC, CAQH Registration can be seamless and straightforward.

2

Timesaving

Automate and submit your credentialing data with ease, saving precious time so you can focus on what matters most – patient care.

3

Compliance Excellence

Stay ahead in the compliance game with tools that keep you aligned with industry standards and regulations.

4

All-in-One Dashboard

Manage all your credentialing information from a single, user-friendly dashboard tailored for healthcare professionals.

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We will help you achieve financial and regulatory compliance goals resulting in improved patient outcomes and increased revenue.