CAQH ProView Updates Enhance Provider Data and Address Industry Needs

CAQH ProView was launched on a new platform in 2015 to enable greater flexibility and growth for the solution. CAQH has been working since the launch to improve the accuracy of the data within the platform, and expand its use in addressing additional, industry-wide provider data needs.

Ongoing system improvements contribute to a timely and accurate exchange of data between providers and health plans. In most cases, CAQH ProView is requesting new information from providers that health plans previously secured through phone outreach, requiring practices to field calls and deliver responses to multiple plans. In other cases, more precise information addresses patients’ need for improved provider directories.

For example, one recent update focused on improving the accuracy of practice locations. According to a recent report from the Centers for Medicare and Medicaid Services, approximately 45 percent of locations in provider directories are incorrect.

As with other information now requested within CAQH ProView, these improvements are intended to reduce the burdens of providers and practice managers sharing this information multiple times, with multiple plans. They can enter the necessary data into CAQH ProView only one time, where it is shared with all authorized plans.

Keeping providers, practice managers and participating organizations informed of these system updates is essential. Outreach to CAQH ProView users is intended to help providers manage their workflows before re-attestation. While the time required to make an update for an individual provider is minimal, it is important that practice managers completing applications for a large group be aware of the total time needed to complete the update.

Some of the updates that have been made to CAQH ProView in 2017 include:

• Providers are now asked to provide more detailed information about their hospital admitting privileges.
• In continued support of state requirements, additional questions were added to address the Colorado credentialing requirements for employment and disclosure information.
• To ensure patients have the phone number required to schedule an appointment, a confirmation field was added to the entry.

Notification of a system update does not require immediate action by providers or practice managers. By providing detailed information about the update and the anticipated time it will take, CAQH aims to alleviate any unexpected work for CAQH ProView users during the re-attestation process, which generally occurs every 120 days.

Questions or suggestions are welcomed and can be sent to ask.proview@caqh.org.