CAQH Provider Data: FAQs for Delegated Groups
CAQH Provider Data enables delegated provider groups to submit a single roster, check it for accuracy and share it with all their health plans in a secure and easy-to-use web portal. Automated workflows notify health plans when new data is available and eliminate the need to prepare and send interim change reports. Delegated groups can see when each plan has downloaded the file. This solution is available to groups at no cost to them.
Designate a group administrator and register here. The group administrator will act as the primary user of CAQH Provider Data.
Log in to your account and download the CAQH Provider template and insert your provider data. Next, download the Practice Locations template and insert your group data. Once your templates are complete, upload your files. Your templates will be checked for errors. If errors are found, you will be able to see and resolve any inaccuracies using the auto-generated error report. Once your files are uploaded, you may assign providers to the locations where they practice.
No, delegated groups only need to submit one roster for all participating health plans.
Group administrators can authorize which health plans have roster access, and the standardized roster format ensures each heath plan only receives plan-specific roster data.
Login to the Provider Data Portal, then search for participating plans and authorize (or de-authorize) which health plans have roster access. Your authorized health plans will be automatically notified when your new roster data is available, eliminating the need for you to send and track emails and attachments.
Authorized health plans automatically receive an email notification when new provider data is submitted and can download it on-demand. Roster history is tracked and recorded, eliminating the need to exchange acknowledgements and status checks by email and telephone.
No, there is no charge for delegated groups.