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Reminder: Changes to the CAQH recredentialing process*

January 30, 2015

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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.

Beginning in February 2015, CAQH is making significant improvements to simplify the recredentialing process even further. Along with these improvements comes a new name: CAQH ProView™.

Benefits of using CAQH ProView

The following new features will make it easier for health care providers to make updates ? reducing the time and resources necessary to submit accurate, timely data to AmeriHealth:

  • 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 in February 2015, all providers must apply online. Paper applications will no longer be 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 to CAQH.

*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.

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