- About CAQH CORE
- Operating Rules
- New Operating Rule Structure
- Eligibility & Benefits
- Claim Status
- Payment & Remittance
- Prior Authorization & Referrals
- Health Care Claims
- Benefit Enrollment
- Premium Payment
- Mandated Operating Rules
- CORE Certification
- Priority Topics
- Join CAQH CORE
- Resource Library
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
CAQH ProView for Groups: FAQs for Delegated Groups
How does CAQH ProView for Groups benefit delegated provider groups?
CAQH ProView for Groups 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.
How is CAQH ProView for Groups different from CAQH ProView?
CAQH ProView enables individual providers to self-report and maintain their professional and practice information in an electronic provider profile, then share it with the healthcare organizations they choose.
CAQH ProView for Groups enables delegated groups to maintain and share their entire group roster in a single, standard format for all health plans using a secure, user-friendly web portal. In addition, the solution includes automatic workflows that save time and improve provider data quality.
Both solutions were developed to increase provider data accuracy and reduce the burden for providers to share their information with health and dental plans and other healthcare organizations.
How can our delegated provider group access CAQH ProView for Groups?
Designate a group administrator and register at groups.proview.caqh.org. The group administrator will act as the primary user of CAQH ProView for Groups.
How do I create or update my group roster?
For your first roster, download the CAQH standard roster template and insert your group data in the appropriate format. “Help” documentation and support staff are available to guide you through this process. Once your roster is complete, login to CAQH ProView for Groups and click “upload roster.” Your roster will be checked for errors. If no errors are present, you confirm the roster and receive a roster summary. If errors are found, you will be able to see and resolve any inaccuracies using the auto-generated error report.
Do provider groups need to submit different rosters for each health plan?
No, delegated groups only need to submit one roster for all health plans participating in CAQH ProView for Groups.
Who can access my group roster data?
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.
How do I share my roster with health plans? Which plans are participating?
Login to CAQH ProView for Groups, 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.
How do health plans know when new roster data has been added?
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 which eliminates the need to exchange acknowledgements and status checks by email and telephone.
What do I do if some of my delegated plans are not using CAQH ProView for Groups?
Group administrators can search for participating organizations and invite them to access their roster data using the “Authorize” function in CAQH ProView for Groups. Please contact email@example.com if your delegating health plan is not listed, so that we can contact them about participating with CAQH ProView for Groups.
Does it cost anything to use CAQH ProView for Groups?
There is no cost for delegated groups to use CAQH ProView for Groups.
Where can I find additional information?
To learn more about how CAQH ProView for Groups would work for your group, please register for a "Groups Perspective" Demo.