What is CAQH?

CAQH, which stands for the Council for Affordable Quality Healthcare, is like a facilitator for healthcare providers. It assists them in giving the right information to insurance companies for things like confirming their qualifications and joining insurance networks. CAQH compliance is often necessary to participate in insurance networks and receive reimbursement for services.

Is your CAQH compliant?

Ever since the No Surprises Act was introduced, the obligation of maintaining precise directories created a joint responsibility between both plans and providers.

  • In accordance with these regulations, providers are required to:
  • Ensure timely submission of updated provider directory information.
  • Promptly inform plans about any changes in network status.
  • Equally, these regulations necessitate plans to:
  • Institute a procedure for verifying provider directory information every 90 days.
  • Effectuate updates within a two-day timeframe upon receipt of information from providers.
  • Enact a process for the removal of unverified providers from the directory every 90 days.

ABA Building Blocks is here to support you.

ABB can provide the following:

  • Expert Consultation: Our team of experienced professionals is ready to provide you with personalized consultations, offering insights and guidance tailored to your specific CAQH needs.
  • Thorough Walkthroughs: We’ll guide you step-by-step, making sure you understand the process and requirements thoroughly.
  • Comprehensive Audits: Our audit services delve deep into your CAQH profile, identifying any discrepancies or areas that need improvement. You’ll receive actionable recommendations to enhance the accuracy and completeness of your profile.
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