Medical Billing Forum

General Category => General Questions => Topic started by: CherylC on October 11, 2009, 10:29:12 PM

Title: CAQH
Post by: CherylC on October 11, 2009, 10:29:12 PM
Hello, I have a question about CAQH. Is there any way a provider can directly apply to CAQH to get their user information so they can complete the CAQH application online?

Thanks,
Cheryl
Title: Re: CAQH
Post by: Michele on October 12, 2009, 07:19:38 AM
I wish!  You MUST have the CAQH number assigned by an insurance carrier.  CAQH will not assign the numbers directly.  We've actually gone to upper level management on this as we do several CAQH applications and it is VERY frustrating to wait for an insurance carrier to assign the number.  I have one I've been waiting over 30 days for and I've applied to 2 different carriers to see which one goes thru first.  If you find a quick way thru PLEASE SHARE!  :)

Michele
Title: Re: CAQH
Post by: cquinn on October 12, 2009, 10:09:39 AM
I have a new billing service and need some clarification for CAQH.  I thought you had to get a CAQH number and then provide that number to the carriers you want to become a perferred provider with to become credentialed with the carrier?????  Is not correct????
Title: Re: CAQH
Post by: Pay_My_Claims on October 12, 2009, 10:21:55 AM
http://www.caqh.org/
Title: Re: CAQH
Post by: PMRNC on October 12, 2009, 10:33:10 AM
I've always used the good ol fashioned DIRECT credentialing route. Never had a problem, have even gotten providers into closed network panels and negotiated contracts and fee schedules. If it ain't broke, don't fix it. LOL
Title: Re: CAQH
Post by: Michele on October 12, 2009, 11:15:17 AM
Some of the carriers do require that you complete the CAQH, but if you don't already have one then they will assign you (the provider) a CAQH number so that you can complete the application, then they continue with the credentialing process.

Michele
Title: Re: CAQH
Post by: CherylC on October 12, 2009, 11:51:44 AM
I'm having the same problem as Michelle, I have sent application paperwork to several insurance companies and I'm waiting for them to assign my provider a CAQH number so I can go in and set up his CAQH account. I have several other insurance companies that require a copy of the CAQH application in order to apply to be in network. I wish they would allow us to apply directly to CAQH! It would make life so much easier! Do you know if an insurance company will only apply for a CAQH number IF they plan on allowing the provider to become in network? I asked BC/BS to get a CAQH number for my provider but they have too many of his provider types in our area so they would only approve the provider for out of network.

Thanks,
Cheryl
Title: Re: CAQH
Post by: PMRNC on October 12, 2009, 06:45:11 PM
I have only encountered carries "encouraging" it not requiring it. It's a third party and it's optional. I have seen the option on most applications but I usually skip over it. Like I said I never have a problem.
Title: Re: CAQH
Post by: Michele on October 13, 2009, 06:53:54 AM
Some of the carriers wait to assign the CAQH # after they have determined if they are going to accept them in the network.  That is the problem.  I have had other carriers assign the number to me over the phone (in which case I threatened to crawl thru the phone line and kiss her!).  Unfortunately I have not found a national carrier that will assign them over the phone!

Michele
Title: Re: CAQH
Post by: Pay_My_Claims on October 13, 2009, 12:26:14 PM
wow now my caqh hurts  ;D
Title: Re: CAQH
Post by: CherylC on October 13, 2009, 01:18:58 PM
My provider is in Ohio and I just talked to the credentialing department at Medical Mutual and was told that they go ahead and apply for the CAQH and don't wait until the credentialing process is over. I was told that if I don't hear anything from CAQH in a couple of weeks to call her back. I'm keeping my fingers crossed.