Why a complete CAQH ProView profile is critical to credentialing success
CAQH ProView is the central credential database used by more than 1,000 US health plans to access provider credentials for network enrollment. An incomplete, inaccurate, or outdated CAQH profile creates downstream problems for every commercial credentialing application that relies on it. The most common credentialing delays we resolve — accounting for the majority of development letters received across our client portfolio — trace back to CAQH profile gaps that were present at application submission.
The 12-section checklist below covers every required element of a complete CAQH ProView profile. Work through each section systematically before submitting any credentialing applications. A profile that is complete and accurate before applications are submitted reaches committee review without a documentation collection step, reducing timelines by 2 to 6 weeks compared to profiles that trigger development letters.
Complete CAQH ProView setup checklist
✓Account Setup
- Create CAQH ProView account at proview.caqh.org
- Note your CAQH Provider ID — you will need this for all payer applications
- Complete CMS Identity and Access (I&A) if applying for Medicare simultaneously
- Set up authorized representative access if a credentialing service will manage your profile
✓Personal and Professional Information
- Legal name exactly as it appears on your state medical license
- Date of birth
- Social Security Number or Individual Taxpayer Identification Number
- National Provider Identifier (Type 1 NPI)
- Home address (required for malpractice verification)
- Primary practice address and all additional practice locations
✓Education Section
- Medical school name, address, and graduation date
- Residency program name, specialty, and completion date
- Fellowship program name, specialty, and completion date (if applicable)
- Internship program name and completion date
✓Professional Licenses
- Current state medical license number, state, issue date, and expiration date — upload a current copy
- All additional state licenses currently held — number, state, and dates
- DEA registration number, state(s), issue date, and expiration date — upload current certificate
- State controlled substance registration(s) where applicable
✓Board Certifications
- Primary specialty board name, certification number, and expiration date — upload certificate
- All additional board certifications held
- Initial certification date for each board
- Board recertification schedule and next due date
✓Work History (10 Years)
- All employment positions for the past 10 years — no unexplained gaps permitted
- For each position: employer name, address, phone, supervisor name, start date, end date, and reason for leaving
- Military service if applicable — branch, rank, dates
- Extended leaves of absence with dates and reasons
✓Hospital Affiliations
- Current hospital name, address, contact, and department
- Admitting privileges or courtesy/affiliate status
- Any hospitals where privileges have been limited, suspended, or revoked — with explanation
✓Malpractice Insurance
- Insurance carrier name and address
- Policy number and coverage type (occurrence or claims-made)
- Coverage limits (per occurrence and aggregate)
- Policy effective and expiration dates
- Upload current certificate of insurance
- Complete claims history for past 10 years: date of incident, claim amount, amount paid, status
✓Professional References
- Three or more professional references — name, specialty, address, phone, and relationship
- References should be physicians or licensed providers who can attest to your clinical competency
- References should not be family members
✓Disclosure Questions
- Medicare/Medicaid/federal program exclusion history
- State license disciplinary actions — sanctions, probations, or restrictions
- Federal or state felony or misdemeanor convictions
- Loss or restriction of hospital privileges
- Malpractice carrier non-renewal or cancellation
- DEA revocations or restrictions
- Any current or pending investigations
✓Payer Authorization
- Authorize every target payer to access your CAQH profile — mandatory before applications are submitted
- Review and update payer authorization list quarterly
- Remove payers you no longer credential with
✓Attestation
- Review every completed section for accuracy
- Complete quarterly attestation — required every 120 days
- Calendar next attestation date 100 days from today to ensure timely completion
Frequently asked questions
How often does CAQH require re-attestation?
Every 120 days. When attestation lapses, CAQH marks your profile inactive and payers who access it receive an inactive status response. This pauses any pending credentialing applications and can trigger recredentialing reviews from payers where you are already enrolled. Setting a calendar reminder 100 days after each attestation is the simplest way to ensure you never miss the deadline.
What happens if I skip a section in CAQH?
Skipping any required section marks the section as incomplete. Payers attempting to access your CAQH profile for credentialing receive an incomplete profile notification, which typically triggers a development letter requesting completion before the application can advance. This adds 2 to 6 weeks to your credentialing timeline per affected payer.
How do I authorize payers to access my CAQH profile?
Log into CAQH ProView, go to the Payer Authorization section, and add each payer you want to authorize. Most major commercial payers appear in the searchable payer list. Authorize every payer you currently bill or plan to credential with. Without authorization, payers cannot pull your credentials and cannot advance your application.
Can I authorize a credentialing service to manage my CAQH?
Yes. CAQH ProView allows providers to authorize designated representatives to manage their profile. You grant representative access with a specific permission level, and the authorized representative can then update sections, upload documents, and complete attestation on your behalf. Niyutsa Technologies manages CAQH as an authorized representative for all our credentialing clients.
What taxonomy code should I enter in CAQH?
Your taxonomy code must match your scope of practice and the taxonomy codes accepted by your target payers for your specialty. Taxonomy mismatch between CAQH, your NPI/NPPES record, and payer applications is one of the most common causes of systematic claim denials. We verify taxonomy code accuracy across all three systems as part of every intake.
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We manage CAQH ProView for 500+ providers — setup, updates, quarterly attestation, and document tracking.