📚Modules 🏠All 50 States 🚀Launch Roadmap ✅Credentialing Tracker
Get Premium — $149 Lifetime Log In

npprivatepracticeguide.com

Module 03 — CAQH Profile

← All Modules

04

CAQH ProView Profile

Complete setup guide — all 18 sections, payer authorization, attestation, and 120-day re-attestation

Most payers will not start credentialing until your CAQH is 100% complete and attested
CAQH ProView is a prerequisite — not a parallel step — for commercial payer credentialing. Complete and attest your CAQH profile before submitting any insurance applications. Incomplete profiles cause applications to sit with no action taken.
A Part 1 — Register for CAQH ProView
CAQH ProView is free for providers. You may receive a CAQH ID from a payer before you register — if so, use that ID. If not, self-register.
1

Check if you already have a CAQH ID

When you apply to an insurance network, many payers automatically generate a CAQH ID for you and send it by email. Check your inbox for messages from CAQH. If you have an ID, go to proview.caqh.org and use it to set up your account. If you have no ID, click “Register” and self-register as a new provider.

  • ↗ CAQH ProView Portal
  • Contact CAQH support if you need your ID: 1-888-599-1771 or providerhelp@proview.caqh.org
2

Create your username and password

Usernames must be 8+ characters, letters and numbers only (no special characters). Choose something you will remember — you will log in to re-attest every 120 days for the rest of your career. Store your credentials in a password manager.

B Part 2 — Complete All 18 Profile Sections
CAQH has 18 data sections. All must be marked complete before you can attest. Plan 3–5 hours for initial completion. Have all documents digitized and ready before you start.
1

Documents to prepare before starting

  • Government-issued photo ID (driver’s license or passport)
  • NP state license certificate (PDF from board website)
  • National certification certificate (AANP or ANCC)
  • DEA certificate (if obtained)
  • State Controlled Substance Registration (if applicable)
  • Malpractice insurance certificate with policy number, limits, carrier name
  • NPI Type 1 and Type 2 confirmation letters
  • EIN confirmation (IRS SS-4 form)
  • CV/resume covering all work history (no gaps — all gaps must be explained)
  • Graduate school transcript or diploma
  • Hospital privileges letter (if applicable — write “none” if no hospital privileges)
  • Practice W-9 form (signed, dated)
2

The 18 CAQH sections — what goes in each

1. Personal InformationFull legal name, DOB, gender, SSN, contact details, languages spoken
2. Professional IDsNPI Type 1, DEA number, state CSR number(s), Medicare PTAN (if applicable)
3. Practice LocationsEvery address where you see patients — name, address, phone, fax, hours, accessibility
4. Specialties & ServicesYour NP specialty, taxonomy code, patient age range, languages, telemedicine offered
5. Education & TrainingNP program school, address, degree, start/end dates, director name
6. Postgraduate TrainingResidency, fellowship, preceptorship if applicable. Write “N/A” with explanation if none
7. Board CertificationsAANP or ANCC certification: cert number, date issued, expiration, certifying body
8. State LicensesAll active RN and NP licenses: state, license number, issue date, expiration date
9. DEA RegistrationDEA number, schedule authority, state, expiration, state CSR if applicable
10. Hospital AffiliationsList all hospitals where you have privileges. If none, list “No hospital affiliations” with explanation
11. Work HistoryAll positions since NP graduation — no gaps allowed. Explain any gaps >30 days
12. Malpractice InsuranceCarrier name, policy number, coverage limits ($1M/$3M standard), retroactive date, contact
13. Professional Liability ClaimsAny malpractice claims history — settled, pending, or dismissed. Must be disclosed
14. Privileges / DisciplinaryAny license restrictions, voluntary relinquishments, disciplinary actions
15. Criminal HistoryAny felony convictions, misdemeanors, sanctions — must be disclosed and explained
16. Billing & Practice InformationTIN/EIN, billing name, billing address, NPI Type 2, billing contact info
17. ReferencesTwo professional references — colleagues who can speak to your clinical competency
18. Supporting DocumentsUpload PDFs of: ID, license, certification, DEA, malpractice certificate, CV
Most common errors that delay credentialing
Name mismatches (must exactly match your state license and NPI records) · Missing documents in Section 18 · Work history gaps with no explanation · Malpractice limits listed incorrectly (write exactly as on certificate: $1,000,000/$3,000,000) · Wrong NPI entered (Type 1 vs Type 2 confusion) · Expired license or certification dates not updated before attestation
C Part 3 — Payer Authorization
After completing your profile, you must authorize each payer you want to credential with. This grants them access to your CAQH data — they cannot view it without your authorization.
1

Authorize all target payers before attesting

In your CAQH dashboard, go to “Authorization” and select each payer you want to work with. You can authorize all listed payers at once with one click — do this. Authorizing a payer does not enroll you with them; it only allows them to view your data. You must still separately apply to each payer’s network.

  • Authorize: Aetna, BCBS (all state BlueCross plans), UnitedHealthcare, Cigna, Humana, Tricare, Optum, Magellan, Beacon Health Options, and any state Medicaid MCOs
  • Payers you did not authorize will show as “Not Authorized” and cannot access your profile
D Part 4 — Attestation & the 120-Day Re-Attestation Cycle
Attestation is your sworn statement that all information in your CAQH profile is true and current. Your profile expires after 120 days without re-attestation — expired profiles block credentialing for ALL payers simultaneously.
1

Initial attestation

Once all 18 sections are complete and all documents uploaded, click “Attest” in the top navigation. Read and accept the attestation statement. Your profile status changes to “Attested” — payers can now access your complete, verified record. CAQH will send you an email confirmation with your attestation date.

2

Set your 120-day re-attestation calendar reminder immediately

Your profile expires exactly 120 days after each attestation. Expired profiles stop payer access — this can result in claim denials and temporary removal from networks. Set a recurring calendar reminder for Day 90 (30 days before expiration) to give yourself time to update any changed information before re-attesting.

  • Re-attestation takes 15–30 minutes if nothing has changed — log in, review all sections, click Attest
  • If you have changes (new address, renewed license, new malpractice policy): update those sections first, then attest
  • CAQH does send email reminders at 30, 15, and 5 days before expiration — but do not rely on these as your only reminder system
The cost of missing re-attestation
Providers who miss CAQH re-attestation can be automatically removed from insurance networks, lose active patient panels, and face claim denials on already-submitted encounters. Reinstatement takes 30–60 days. A 15-minute calendar reminder every 4 months prevents all of this.

Next ModuleModule 05 — Credentialing→