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New CAQH recredentialing process now in effect*

March 2, 2015

AmeriHealth offers our participating providers the Council for Affordable Quality Healthcare® (CAQH) Universal Provider DataSource® (UPD) for completing the recredentialing process. The CAQH UPD is a single, national process that eliminates the need for completing multiple recredentialing applications.

As previously communicated, CAQH made significant improvements to simplify the recredentialing process even further. Along with these improvements came a new name: CAQH ProViewTM. The launch of CAQH ProView is scheduled for March 2, 2015.

Benefits of using CAQH ProView

The following new features make it easier for health care providers to make updates — reducing the time and resources necessary to submit accurate, timely data to AmeriHealth. CAQH Proview gives providers the ability to:

  • complete and attest to multiple state credentialing applications in one intelligent workflow design;
  • upload supporting documents directly into CAQH ProView to eliminate the need for manual submission and to improve the timeliness of completed applications;
  • review and approve Practice Manager information before data is imported;
  • protect against delays in data processing with more focused prompts and real-time validation;
  • self-register with the system before a health plan initiates the application process.

New submission process

When CAQH ProView launches, all providers must apply online. Paper applications are no longer accepted. CAQH ProView is a completely electronic solution, allowing providers to easily submit information through a more intuitive, profile-based design. The CAQH electronic credentialing application is free to providers and available on the CAQH website. AmeriHealth may still request paper documentation, such as billing forms and contracts; however, the initial credentialing and recredentialing process with CAQH will be paperless.

Note: Providers in New Jersey can also use the New Jersey Universal Physician Application form.

If you have questions about CAQH ProView, please email them.

*This does not apply to Magellan Behavioral Health contracted providers.

Magellan Behavioral Health, Inc. manages mental health and substance abuse benefits for most AmeriHealth members.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of AmeriHealth, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey.
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