- 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 Terms of Service
Effective Date: May 22, 2018
|What is Changing?|
Effective May 22, 2018, CAQH will be updating the CAQH ProView Terms of Service. You can view the entire revised Terms of Service agreement below.
These changes include updates to the Introduction section and Section 5 (ProView Terms Inquiries) to better align the terms with CAQH procedures and obligations. They also include updates to Section 1 (The Service), Section 2 (User Submitted Data), Section 3 (Your Log-in and Account Information), and Section 4 (Release from Liability) to take into account new CAQH ProView functionality.
To summarize, these changes to the Terms of Service include:
The following CAQH ProView® (formerly Universal Provider Datasource (“UPD”)) Terms of Service (the “CAQH ProView Terms”) are applicable between the Council for Affordable Quality Healthcare, Inc. (“CAQH”) and users registering on this site (“You”) to access and use CAQH ProView (the “Service”), and its current and future related sites, including sections of the site relating to CAQH ProView accessible at https://proview.caqh.org (collectively, the “Site”). CAQH reserves the right to alter these CAQH ProView Terms at any time; if CAQH amends these CAQH ProView Terms, CAQH will post such changes and specify the date they are effective, which means that the amended version of these CAQH ProView Terms will control when you utilize the Service after the respective effective date. The current version of these CAQH ProView Terms showing the effective date is always available at this location.
Without limiting the general applicability of the CAQH General Terms of Service, these CAQH ProView Terms also apply with respect to your use of the Service. If there is a conflict between the CAQH General Terms of Service and these CAQH ProView Terms, these CAQH ProView Terms will control.
YOU MUST READ AND AGREE TO THESE CAQH PROVIEW TERMS AND THE CAQH GENERAL TERMS OF SERVICE, BEFORE USING THE SITE OR SERVICE. BY USING THE SITE OR SERVICE, YOU AGREE TO THESE CAQH PROVIEW TERMS. IF YOU DO NOT AGREE TO THESE CAQH PROVIEW TERMS OR THE CAQH GENERAL TERMS OF SERVICE, YOU MAY NOT ACCESS OR USE THE SERVICE OR SITE. In some cases, users will be required, as a condition of working with certain healthcare organizations, their health plans, and other participating organizations to utilize the Service. This condition is imposed by the participating organization and not by CAQH; if you have any questions or concerns in this regard please contact the applicable participating organization.
You acknowledge and agree that these CAQH ProView Terms may not be modified by you by any means, including sending an electronic message, and any such attempted modification shall be void.
You represent and warrant that you have all necessary rights required to comply with the commitments and obligations set forth in these CAQH ProView Terms including all necessary rights to share User Submitted Data.
1. THE SERVICE
CAQH ProView was designed to eliminate duplicative data entry and processing activities and bring efficiencies to healthcare. The data in CAQH ProView has many potential uses, including, for example, the collection of data for credentialing purposes, collection of data for medical malpractice insurance purposes, delegated credentialing oversight, conducting research, enrollment in health information exchanges, and maintenance of provider directories.
By using the Service, you authorize and direct CAQH as your agent to transmit User Submitted Data that is held in CAQH ProView to Service Recipients. BY REGISTERING AT THE SITE, YOU AUTHORIZE CAQH TO ACT AS YOUR AGENT TO TRANSFER THE USER SUBMITTED DATA TO ONE OR SEVERAL SERVICE RECIPIENTS YOU DESIGNATE. YOU ALSO AUTHORIZE CAQH FROM TIME TO TIME TO MODIFY OR SUPPLEMENT THE USER SUBMITTED DATA TO SERVICE RECIPIENTS YOU DESIGNATE.
2. USER SUBMITTED DATA
By using CAQH ProView, you authorize each Service Recipient, including without limitation its affiliate(s) and their respective representatives, employees, and/or designated subcontractors or agent(s), and, to the extent applicable for healthcare organizations, a designated professional credentials verification organization (collectively referred to as “Agents”), to receive and investigate information concerning the User Submitted Data that you provided, and/or application for participation. You understand that this may include oral and written statements, records and documents. You agree to allow any such Service Recipient and/or its Agent(s) to inspect and copy all records and documents in CAQH ProView relating to such an investigation. The CAQH process requires that each Service Recipient and its representatives, employees, and agent(s) acknowledge that the information obtained relating to the application process will be held confidential to the extent permitted by law unless otherwise agreed by you and such Service Recipient.
CAQH may share User Submitted Data that you provided with health plans, hospitals and other organizations to which you affirmatively give access through the authorization process. The use of User Submitted Data that you provide by such organizations may be the subject of a separate agreement between providers and the organization(s). If you elect to make changes to the list of organizations that may receive User Submitted Data that you provide, please know that the change will be made as soon as practically possible. In the case of a deletion, that information may have been disclosed to that organization under your prior authorization; deleting an organization will not delete the information previously received by that organization.
CAQH may also share User Submitted Data that you provide with health information exchanges (HIEs), and other agencies or entities implementing or managing governmental programs (including emergency service responder registries) that have jurisdiction over your professional practice, whether or not included on your list of organizations that may receive the User Submitted Data that you provide.
For purposes of the CAQH ProView Group Module, “Personal Information” includes any information that identifies an individual including you or a provider in your group practice, would enable someone to contact you or a provider in your group practice, or that describes your relationship or a provider in your group practice’s relationship with CAQH.
CAQH ProView will ask You to submit and attest to or confirm User Submitted Data that you provide upon registration with the Site, and to maintain and re-attest to or re-confirm that data on a recurring basis. CAQH will make reasonable efforts to check that User Submitted Data is sufficient, accurate and attested to or confirmed before making such data available to Service Recipients authorized by You. Service Recipients will have access to Content through the Site, as well as through electronic files that are delivered to Service Recipients on a scheduled basis.
3. YOUR LOG-IN AND ACCOUNT INFORMATION
You are required to use a username and password in order to register and to access portions of this Site.
As a user of the CAQH ProView Individual Provider Module, you may authorize your practice administrators to input information for you through the Practice Administrator Module. Practice Administrators using this website can only interact with providers with whom they have an association.
You are responsible for verifying all User Submitted Data entered on the Site. While CAQH may perform validation of certain information User Submitted Data, You are responsible for correcting any mistakes, omissions or other errors.
4. RELEASE FROM LIABILITY
You release from all liability and agree to hold harmless CAQH and any Service Recipient, its Agent(s), and any other third party for their acts performed in good faith and without malice unless such acts are due to the gross negligence or willful misconduct of the Service Recipient, its Agent(s), or other third party in connection with the gathering, release and exchange of, and reliance upon, information used in accordance with the CAQH General Terms of Service and these CAQH ProView Terms of Service. You further agree not to sue CAQH or any Service Recipient, any Agent(s), or any other third party for their acts, defamation or any other claims based on statements made in good faith and without malice or misconduct of such Service Recipient, Agent(s) or third party in connection with the credentialing process or other process used for evaluation of your (or the individual on behalf of whom you are submitting User Submitted Data) qualification for Participation. This release shall be in addition to, and in no way shall limit, any other applicable immunities provided by law for peer review and credentialing activities. In these CAQH ProView Terms, all references to the Service Recipient, its Agent(s), and/or other third party includes their respective employees, directors, officers, advisors, counsel, and agents.
5. CAQH PROVIEW TERMS INQUIRIES AND OPT-OUT/INFORMATION CORRECTION OR REMOVAL
Any inquiries concerning these CAQH ProView Terms should be directed to: firstname.lastname@example.org.
If any of the information that we have about you is incorrect or you wish to have information removed from our records, please contact us at ITSecurity@caqh.org. CAQH maintains administrative records of your information pursuant to these Terms of Service and applicable law. Even after you cancel, deactivate or delete your account, we will retain a record of your information for administrative purposes to be used as necessary to comply with our legal obligations, resolve disputes, and enforce our agreements.