What is CAQH and how do you set it up?

You cannot get paneled with any of the four major commercial networks without a CAQH profile, which makes it the first real piece of credentialing work. Here is exactly what to build, screen by screen, and the two settings that silently stall applications.

What is CAQH ProView?

CAQH ProView is a shared database, not a decision-maker. Payers pull your profile from it to run their own verification; CAQH itself approves nothing. The official name is now the CAQH Provider Data Portal, but every payer rep, therapist forum, and application form still says "CAQH" or "ProView," and the login is still proview.caqh.org.

The practical consequence: a complete, attested profile means a payer can start verifying you the day your application lands. An incomplete one means the payer waits. Some payers wait silently, without telling you what's missing.

Do you need a CAQH profile?

If any of the four major commercial networks is on your list, yes. Aetna, Anthem BCBS, Cigna, and UnitedHealthcare (including Optum, its behavioral health arm) all build their credentialing review on a CAQH pull. Set the profile up before you submit anything, or the application stalls on day one.

Medicare enrolls through PECOS, most state Medicaid programs have their own portals, and a handful of regional payers still use paper applications. But those are the exceptions. For commercial panels, assume CAQH first.

How do you set up a CAQH profile?

Go to proview.caqh.org, click Register, and enter your Type 1 NPI; the account cannot be created without one. CAQH assigns you a CAQH ID (an eight-digit number); save it, because every payer application asks for it. From there the portal walks you through the profile sections: personal information, education, training, work history, references, malpractice coverage, and licenses.

Three fields cause most of the pain, so get them right the first time:

• Legal name. Enter it exactly as printed on your state license. A missing middle initial or a hyphenated-versus-unhyphenated surname is enough to flag a payer's primary-source verification. Name mismatches cause more returned applications than the next three reasons combined.
• Work history. CAQH expects the past ten years with no unexplained gaps of 30 days or more (some payers review only the last five, but build the profile to the stricter standard once). A one-line explanation (parental leave, moving states, career change) beats a blank every time. The full treatment is in how to handle CV and work history gaps.
• Malpractice dates. The effective and expiration dates you type must match your certificate exactly. Transposed month and day is a classic rejection.

When the sections are done, the Review screen shows a data summary PDF. Read it as a payer would before you touch the Attest button. paneled.ai runs this same review for you during intake, checking the profile against the mismatches that most often bounce applications.

What documents does CAQH require?

Upload your active state license and your malpractice certificate of insurance at minimum; add your DEA certificate and board certification only if you have them. The malpractice upload is where behavioral health providers get tripped: CAQH wants the declarations page (the face sheet naming you as the insured, with coverage limits and effective dates), not the payment receipt, not the quote, not the application.

CAQH reviewers check each upload within about 2–3 business days, and they reject documents that are expired, missing a signature, or signed more than 120 days before your attestation. A rejected document doesn't always generate a loud alert, so check the Documents section status after every upload.

The classic version of this mistake is uploading the malpractice carrier's premium invoice instead of the declarations page. CAQH rejects it within a few days, and if the rejection notice goes unread, the payer application sits in "outstanding documents" until a status call surfaces the problem. A fix that takes ten minutes can cost five weeks of stalled review.

What does the "authorize payers" setting actually do?

Authorization is the switch that lets a payer pull your data; a complete profile does nothing until it's flipped. In the Authorize section of the portal, you either grant global authorization (any participating plan can access your profile) or check plans individually. Global is the low-maintenance choice for most solo providers; individual authorization only makes sense if you have a specific reason to wall off a payer.

Two things authorization is not. It is not an application: you still submit a separate network participation request to each payer. And it is not retroactive notice: if a payer tries to pull your profile before you've authorized them, some will email you, and others simply let your application sit.

What happens every 120 days?

Your attestation expires 120 days after you click Attest, and payers cannot pull an unattested profile. CAQH emails reminders as the deadline approaches, starting about 30 days out and again at 15 and 7 days, but those emails routinely land in spam folders or go to an old practice address, so don't build your system on them. Set your own recurring calendar reminder at 90 days.

Re-attesting takes under five minutes when nothing has changed: log in, review, click Attest. Miss it and the profile flips to inactive, pausing any application in flight, usually without the payer telling you. The full mechanics, including how to recover a lapsed profile mid-application, are in the CAQH 120-day re-attestation rule.

CAQH setup checklist, ordered by screen

Once your profile is attested and payers are authorized, you're ready to pick panels and submit. Start with which insurance panels to join and the full credentialing checklist.