What comes to mind when you think of “provider credentialing”? If you’re a physician or medical office staff member, mundane paperwork and hours of frustration are likely front-of mind associations. After all, staying continuously credentialed with dozens of commercial insurers and Medicare can create administrative hassles taking days away from patients. Enter the CAQH website.
Fortunately, help exists thanks to the Council for Affordable Quality Healthcare’s incredible free resource known as CAQH ProView. This centralized online platform totally transforms the tedious recredentialing process that previously devoured hours hunting for provider diplomas, licenses, and malpractice coverage documents across different filing cabinets each year per payer.
Here’s how this invaluable time saver works: medical providers simply visit the CAQH website to register and begin inputting all their critical credential documentation like NPI numbers, education backgrounds, training certificates, specialty qualifications and basic demographic data into the secure online profile. After comprehensively populating details spanning training histories to work experiences at various healthcare facilities just once, individual doctors can then authorize specific insurance companies access to this centralized reliable repository holding everything needed.
Voila – the next time your contract with Aetna, UnitedHealthcare or other major insurer comes up for renewal, they can pull required credential verification materials straight from the system rather than making burdensome piecemeal requests stretching staff resources thin shuffling paperwork. CAQH maintains stringent security compliance easing any confidentiality concerns. Participation also helps convey transparency and confidence in capabilities to contracting payers.
But wait – incredible time savings just scratch the surface of CAQH’s potential. Ongoing access also helps payers keep rosters of currently credentialed providers completely up to date for member site listings. This ensures patients know which doctors participate in-network as they search for highest quality affordable care options in their geographical area. Accurate accessible details also smooth referrals coordination between interdisciplinary care teams.
In effect CAQH ProView integration lays integral groundwork enabling the critically shifting reimbursement paradigm emphasizing value over volume. They help streamline otherwise resource-draining business requirements so high-value patient centric medicine can take center stage. Any clinician seeking an efficient way to confidently convey qualifications while participating in network contracts must enroll today.
If you have questions about the CAQH or need help with getting your profile setup, give us a call at (844) 424-5537 or send us a message here.
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