Universal Provider Datasource®

The Online Application System (OAS) is a secure, free, Internet-based system made available to you by organizations participating in the CAQH initiative. The OAS will allow you to complete your application online and transmit it electronically to participating organizations or print hard copies to forward to non-participating organizations.

First-time users of the OAS will need a CAQH ID in order to complete the registration process. If you have not received a CAQH Provider ID, please contact your health plan to confirm that they are participating.

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Above are links to printable versions of the CAQH application, supplemental forms and reference codes. The supplemental forms allow you to provide additional information where appropriate. The reference codes are used to answer questions specific to your license type.

If you do not have Adobe Acrobat Reader click here for a free download.