Author Topic: CAQH question  (Read 1780 times)


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CAQH question
« on: July 03, 2012, 03:10:16 PM »
I would like to enter some of my clients into CAQH.  Then when enrolling into another insurance program, will already have most of their information in CAQH.  However, CAQH doesn't give out Provider ID's to start the process. They say you have to get the provider rep. from the insurance co. you are wanting to particiapte in to assign a CAQH provider number and she/he will let you know what the number is.  My clients are not participating network providers in any insurance companies, b/c they are individual PT, OT, or ST's who treat patients in the patient's homes.  Most  of their patients are disabled children on Medicaid.   Unless they are a Home Health agency, regular commercial ins. companies will not let them be in the network.  However, my clients are Medicaid providers.  And Medicaid has numerous, numerous different Medicaid programs now that my clients want to participate in, but these Medicaid HMO type programs do not give provider numbers for CAQH.  I've called several and they say, you have to get a provider number from CAQH - it goes back and forth.  Only providers I've been able to get into CAQH are the ones who are able to be enrolled into a commerciel insurance company, like Blue Cross Blue Shield b/c those providers are in a facility.    When I call the Medicaid HMO's they say they will get info from CAQH if I put the CAQH number on the application-  but I can't get them to initiate the provider number in order to get started.   Hope you understand my question.
I'm in Texas - Medicaid programs I'm talking about, to name a few, are Molina, Superior, Health First, Bravo, Amerigroup, First Care - there are lots more.


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Re: CAQH question
« Reply #1 on: July 04, 2012, 08:20:23 AM »
Have you tried going straight through Medicaid? I do all my credentialing manually direct with the carriers and avoid the Middleman, just easier for me. I would try that and go from there.
Linda Walker
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Re: CAQH question
« Reply #2 on: July 04, 2012, 06:07:15 PM »
I just experienced this with a new provider that wasn't credentialed with any carriers.  Basically I contacted BCBS to start the credentialing process and they were the ones who issued her CAQH number, then I was able to login and complete her application making it available to all insurance companies.

CAQH is correct, they do not initially assign the numbers, the insurance companies do.
Shontel Littles
" Show Me The Money"