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Ryan Smith, DDS

CAQH

A shared online database where a dentist's credentials are stored once and accessed by many insurance plans for enrollment.

Also called: Council for Affordable Quality Healthcare

CAQH, short for the Council for Affordable Quality Healthcare, runs a shared online profile system where a dentist enters their credentialing information (license, education, malpractice history, practice locations, NPI) once, and participating insurance plans then pull from that single profile instead of each requiring a separate paper application. It exists specifically to reduce the redundant paperwork of credentialing with multiple plans at once, which matters most when a practice is joining several networks in a short period.

The catch is that a CAQH profile has to be actively kept current (attested to on a regular cycle, typically every 120 days) or it goes stale, and a stale profile can silently stall a credentialing or recredentialing application with any plan that relies on it, even if every underlying fact about the dentist is unchanged.

Assigning ownership of the practice's CAQH profile to a specific person, with a calendar reminder for the attestation window, prevents one of the more avoidable causes of a delayed or denied claim: a plan unable to verify credentials because the shared file behind the scenes simply expired.

Where it comes up

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