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CAQH ProView – Help Page

Provider Help:

Question Answer
1. What is CAQH? CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans. For more information, please visit www.CAQH.org.
2. What is CAQH ProView? CAQH ProView – previously known as CAQH Universal Provider Datasource – is an online provider data-collection solution. It streamlines provider data collection by using a standard electronic form that meets the needs of nearly every health plan, hospital and other healthcare organization.

CAQH ProView enables physicians and other healthcare professionals in all 50 states and the District of Columbia to enter information free-of-charge into a secure central database and authorize healthcare organizations to access that information. CAQH ProView eliminates redundant paperwork and reduces administrative burden.
3. What business challenge does CAQH ProView help solve? By streamlining data collection electronically, CAQH ProView is reducing duplicative paperwork and millions of dollars of annual administrative costs for one million physicians and other health professionals, as well as over 650 participating health plans, hospitals and healthcare organizations.
4. What administrative processes does CAQH ProView help simplify? CAQH ProView is the trusted source and industry standard for collecting provider data used in credentialing. In the future, this data can also be used for claims processing, quality assurance, emergency response, member services and more.
5. What is credentialing? Healthcare organizations such as health plans and hospitals evaluate physicians and other health care providers with whom they contract to confirm that these providers are adequately trained, certified and/or licensed to provide care. One of the most important parts of the credentialing process is the collection and verification of vital data regarding the healthcare provider's education, training, experience, practice history, location, disclosure of any issues impacting their ability to provide care, and other background information.
Three steps are involved in completing the credentialing process:
  • CAQH collects self-reported data from providers (education, training, location, etc.). This is the information that CAQH ProView collects and shares with organizations the provider chooses.
  • Participating Organizations verify certain provider-reported data against third-party sources, also called Primary Source Verification.
  • Participating Organizations review the data in order to make an independent decision about whether the provider in question meets the standards of an organization required to provide care.
6. Why is administrative simplification for credentialing an important issue? Administrative simplification of the credentialing process helps providers increase their compliance with an organization’s requirements. The paperwork associated with credentialing is a time-consuming task facing physicians, other health care providers, practice managers and healthcare organizations. A typical healthcare provider contracts with 10 - 20 healthcare organizations, each requiring the provider to complete an extensive credentialing application.

CAQH ProView simplifies the process by enabling providers to submit one standard credentialing application to a single source, the CAQH ProView credentialing application database, to satisfy the credentialing requirements of participating health plans. This significantly reduces the administrative requirements associated with the credentialing application process.
7. Where can I get additional information about this solution? Please visit https://proview.caqh.org/pr for more information on CAQH ProView.
8. Who is able to access CAQH ProView? Every health plan may use CAQH ProView if they choose to participate. Other healthcare organizations that handle credentialing functions on behalf of health plans – or that have their own need for credentialing –may also choose to use the solution. In all cases, providers must submit authorization for a health plan to access their information.
9. Does it cost anything to use CAQH ProView? There is no cost for physicians and other health care providers to use CAQH ProView.
10. How can I access CAQH ProView? You can register online at https://proview.caqh.org/pr, or you will receive registration instructions once a healthcare organization notifies CAQH that you need to access the database. Once registered, you can use your CAQH Provider ID and password to access CAQH ProView.
11. How often must I update my information? You will be sent automatic reminders to review and attest to the accuracy of your data. You must review and authorize data once every four months. You can attest and make changes to your record anytime by accessing your information online.
12. Do I need to complete the entire profile? Yes. You must complete all profile questions. The CAQH ProView profile will present questions that are relevant to your particular specialty, provider type and practice location(s). The system is designed to allow you to complete your profile over time. You can stop any time, save what you have completed, and return later to finish the process. The entire profile must be completed prior to your verification of its accuracy, and before the participating health plans that you have authorized can access it.
13. Can I use CAQH ProView to report any changes to my practice such as address and phone number? Your agreement with each of the health plans and healthcare organizations typically requires you to communicate certain changes to your personal information immediately. Rather than contact each of these organizations individually, you can enter your changes once into CAQH ProView. Only organizations that participate in CAQH ProView and that have been authorized by you to access your information will receive any changes. You will still need to contact any non-participating organizations directly.
14. Can any organization access my data? No. You control which organizations have access to your information. When completing your profile, you will indicate which healthcare organizations and health plans are authorized to access your data.
15.What if I am affiliated with an organization that is not participating in CAQH ProView? If you are affiliated with an organization that is not participating in CAQH ProView, you will need to continue to work with that organization directly. Healthcare organizations and health plans are invited to participate in CAQH ProView, regardless of whether they are members of CAQH. If one of the health plans with which you work is not currently using the solution, please ask them to visit the CAQH website at www.CAQH.org or call 202-861-1492.
16. Who do I contact for administrative support questions when utilizing the system? Please contact the CAQH Help Desk by calling: 1-888-599-1771 or via email at providerhelp@proview.caqh.org. Help Desk hours are:
  • Monday – Thursday: 7 AM – 9 PM (EST)
  • Friday: 7 AM – 7 PM (EST)
17. How will the confidentiality and security of provider information be ensured? The confidentiality and security of provider information and the privacy of system users are critical priorities for CAQH. CAQH ProView is designed to be compliant with federal and states laws, rules and regulations relating to the privacy of individually identifiable health information. In addition, CAQH will comply with applicable laws and regulations pertaining to confidentiality and security in the development of the database and the data collection process.

The CAQH database is housed in a secure Tier 3 Datacenter. Access to the cage is limited to authorized Support staff and controlled by multiple levels of physical security. All network traffic to and from the center is routed through redundant firewalls for complete security to the database and online systems. Secure Internet accesses to application screens, use of passwords, electronic signatures/certificates, and powerful Secure Socket Layer (SSL) encryption are used to ensure only authenticated use of the system. Only password/PIN-authenticated users have access to their restricted data over connections that automatically encode all information exchanges. Virus detection mechanisms are used to ensure that the database and the Websites are free of all viruses. Routine encrypted back-ups protect all volatile system data and are secured in an off-site storage facility.