CAQH ProView: A Practical Guide for Providers
Nearly every payer pulls credentialing data from CAQH ProView — and an expired or incomplete profile quietly stalls enrollments and payments. Here is how CAQH works and how to keep your profile clean.
If you bill US health plans, you have a CAQH profile whether you manage it or not. CAQH ProView is the central database where providers enter their professional and practice information once, and health plans then pull that data to credential and re-credential them. Keeping the profile complete, current and attested is unglamorous — and absolutely load-bearing, because payers cannot finish enrollment or revalidation for a provider whose CAQH record is incomplete or expired.
What information CAQH ProView holds
- Personal and demographic details, including NPI and practice locations
- Education and training history
- State licenses, DEA registration and board certifications
- Malpractice insurance details and coverage history
- Work history and hospital affiliations
- Disclosure questions about sanctions, exclusions and malpractice history
- Supporting documents uploaded as files — license copies, certificates, insurance face sheets
Setting up a profile, step by step
- Register — most providers are first invited by a participating health plan; self-registration is also possible. You will receive a CAQH provider ID.
- Complete every section — partial profiles cannot be attested, and payers see only completed, attested data.
- Upload documents — current license, DEA (if applicable), malpractice certificate and other requested records, in legible copies.
- Authorize the plans — choose which health plans may access your data; "global authorization" lets all participating plans pull it.
- Attest — review the whole record and formally attest that it is accurate. Only then does your data become available to payers.
The 120-day attestation rule
Attestation is not one-and-done. CAQH requires providers to re-attest their data every 120 days — confirming nothing has changed, or updating what has. Let attestation lapse and the profile shows as expired to payers, which can hold up credentialing, re-credentialing and directory listings until it is renewed. Put the date in a calendar with a reminder well before day 120; better, make attestation someone's named responsibility rather than everyone's assumption.
Common CAQH mistakes that delay credentialing
- Expired documents — a license or insurance certificate that lapsed in the file while the real one was renewed.
- Data that disagrees with other records — names, addresses or taxonomy that do not match the NPI registry (NPPES) or PECOS create verification loops.
- Practices not updated — old locations left active, new locations never added.
- Plans not authorized — the payer you are enrolling with cannot see your data because it was never given access.
- Attestation lapses — the profile quietly expiring mid-enrollment.
What happens after you attest
Once your profile is attested, authorized plans can pull your data for initial credentialing and for the periodic re-credentialing that plans perform on their networks — typically on a cycle of about three years, though the exact timing is each plan's own policy. Between cycles, plans may also use CAQH data to keep their provider directories accurate, which matters because patients choose practices from those directories: an address or phone number that is wrong in CAQH can be wrong everywhere it feeds. When anything material changes — a new license, a new location, a change in malpractice coverage — update CAQH at the time of the change rather than waiting for the next attestation window, and re-attest so the new data is what payers see.
How CAQH fits into credentialing overall
CAQH is one piece of the enrollment puzzle, alongside payer applications, PECOS for Medicare, and EDI/ERA/EFT setup. Our explainer on credentialing and enrollment maps the whole process, and if you would rather hand the upkeep to a team that watches attestation dates and document expiries for you, that is precisely what our CAQH service and wider credentialing and enrollment support exist for.