CAQH Solutions Release Archive for Participating Organizations

CAQH ProView Release for today, March 16, 2020: 

Hospital Closure has been added to reasons for Privilege Discontinuance

When providers indicate their Admitting Privilege Status is inactive for an affiliated hospital, they must choose a Reason for Discontinuance. Previously, CAQH ProView did not have an option to include hospital closures.

With this release, "Hospital Closed" has been added as a fourth option in the drop-down menu along with Voluntary Resignation, Suspension and Termination with Cause. This will help providers enter more accurate data.

Document Name Change on the Documents Screen

The document previously titled Application Release in the Document Name drop-down in CAQH ProView, has been updated to Standard Authorization, Attestation and Release to more accurately reflect its contents.

These changes are in name only with the goal of providing more clarity and only affects CAQH state forms. Non-CAQH state application release forms will remain the same, as will extracts and the documents API.
 

DirectAssure® Release for March 16, 2020:

Timestamp added to collect Affiliation Response Changes

With this release, a timestamp is now being collected when providers respond to an affiliation question. Providers are required to respond to an affiliation question to show plans how they engage with patients at a specific practice location. A provider may indicate that they see patients by appointment on a weekly basis, or that they only read tests or cover for colleagues at a given location. Previously, it was difficult to determine if the response given by the provider was one week old, or one year old. As time passes, the way a provider engages with that location may also change.

By implementing a timestamp to show the last time the data has been updated, it provides plans with additional context about the information they are seeing, allowing the plan to make more informed business rules around how to process data. The inclusion of this timestamp will allow CAQH to better analyze the quality to age ratio. One likely outcome with this new enhancement could be a new capability prompting providers to review older affiliation responses at regular intervals, improving data quality.

Qualified Autism Service Provider (QASP) Certification

CAQH is now collecting QASP certification details within ProView and is making that information available to Participating Organization’s in the DirectAssure extract. Beyond helping to meet regulatory requirements, having this information helps plans better display providers specializing in autism spectrum disorders in their member directories.

If selected, Providers are required to include the QASP certification number. They may also include the start date, and expiration date of the certificate. This data is available in a new Certifications object within the DirectAssure API.

CAQH ProView for Groups® Release for March 16, 2020: 

Add an Extension to Your Contact Number

With this release, you are now able to include an extension in your contact phone number in your profile. See a screenshot below: 

Watch Training Videos

Refresh your memory or teach new users to do the most common things in CAQH ProView for Groups. In the help section, you will are now able to find a new series of two-minute instructional videos to learn how to:

  • Add a user;
  • Authorize or revoke health plan access to your roster;
  • Add locations;
  • Add new providers and their practice locations;
  • Specify which health plans should get a provider's information;
  • Use an error report;
  • Terminate a location; and
  • Remove a provider from your roster.

 

CAQH ProView Release for February 18, 2020: 

The CAQH ProView release for today, February 18, 2020 is designed to help meet Illinois state requirements. 

The Illinois recredentialing application has been added to CAQH ProView

With this release, you are now able to download both the initial and the recredentialing applications for all Illinois providers to help meet state requirements. You have access to both the initial and recredentialing applications regardless of how long a provider has been rostered. This feature allows providers to "preview" what their data looks like on the recredentialing application. 

 

DirectAssure® Release for January 21, 2020: 

We're greeting the new year with the addition of some new and eagerly awaited functionality to DirectAssure: 

Direct Access to Outreach Compliance Reports 

The Outreach Compliance Reports are now available via the DirectAssure Portal. Additionally, we have expanded the report's availability from 30 days to up to 12 months. 
 
See the new Outreach Compliance Reports below:

New API Method to Return CAQH IDs

To foster insightful and streamlined reporting, two new APIs have been created to return CAQH IDs by attestation date and CAQH ID number.
 
Now you are able to provide an attestation date and receive a list of CAQH IDs of providers who have attested on that specific date. Previously, you were provided a day's worth of attestations however, the new API enables you to drill-down to a specific provider. 
 
You also have the ability to provide a CAQH ID number and receive a current DirectAssure extract for that individual. 

 

VeriFideTM Release for January 11, 2020: 

We're greeting the new year with the addition of some new and eagerly awaited functionality to the VeriFide Portal: 

Status Charts for Initial Credentialing and Urgent Re-credentialing 

The first release of the VeriFide Portal featured a chart showing the status of your Normal Re-Cred Primary Source Verification (PSV) Orders. With this latest release, that capability has been extended to include two more charts showing the statuses of Initial Credentialing and Urgent Re-Cred PSV Orders. For those of you using VeriFide for Initials and Urgent Re-Creds, these new charts will give you much-needed visibility into the status of these types of Orders as they are processed, eliminating the need for guesswork or to contact the VeriFide support center to find out the status of an Order.
 
See the new status charts below:



These charts are now shown on the “Order Status” tab of the VeriFide dashboard along with the Normal Re-Cred status chart. They function very similarly to the Normal Re-Cred chart, with the key difference being that Orders are grouped by the week they were placed, compared with Normal Re-Creds that are grouped by the month of the Scheduled Decision Date. This reflects the different processing time frame used for Initial Credentialing and Urgent Re-Cred Orders.

 
By default you will see Orders placed within the past eight weeks, but you are now able to choose a different time frame. Just like the Normal Re-credentialing chart, you can click on a particular bar or section of the donut chart to drill down further.
 
The VeriFide Business Users’ Reference Guide (available within the ‘Resources’ card in the VeriFide Portal) has been updated with details of these new charts.

 

CAQH ProView Release for December 9, 2019: 

The CAQH ProView release for today, December 9, 2019 is designed to give participating organizations near real-time access to a list of all approved provider documents through the Provider Supporting Documents API. Additionally, an enhanced version of the Credentialing API has been released as well as updated Domain Table Lists for Hospitals and Specialty Boards.

Enhanced the Documents API to Return a List of all Provider’s Approved Documents 

The Provider Supporting Documents API is a web service that gives a participating organization access to a provider’s document(s) in near real-time. This allows seamless integration with participating organization-based systems that utilize documents for internal processing. A participating organization can now make an API call for a provider’s supporting document(s) instead of accessing them through the participating organization’s portal or receiving them through a standard or custom extract.
 
With the latest release, participating organizations can now use the API to request a list of all approved documents for a rostered provider by CAQH ID.
 
The response will return a list of all approved documents along with:

  • Document Name
  • State (if applicable)
  • Expiration Date (if applicable)
  • Document URL
  • Received Date

Participating organizations can then make a second API call to request the specific document(s) by CAQH ID and Document URL.

Credentialing API Includes Additional Fields 

Credentialing API web service can be used by participating organizations to access real-time provider data from CAQH ProView.

An enhanced version of the Credentialing API has been released to include the following additional fields:

  • Unique ID for each disclosure question
  • Primary Credentialing Contact (Yes/No)
  • Malpractice Claims Settlement Date
  • CAQH Practice Location ID to the XML
  • Billing Address and Employment Information
  • Admitting Arrangements
  • Other Practice States

This is Version 4 of the credentialing API. Previous versions of the API will continue to be supported and plans may decide to implement the new version at their convenience.

Practice Location Submissions

Participating organizations will now be able to upload provider location data for practice location reconciliation through the participating organization portal.
­
Files submitted through the portal can contain no more than 200 thousand provider locations. When the file is submitted, initial validation of the file will ensure that the file is formatted properly. Processing will be complete within 24 hours.
 
Current and historical files, along with corresponding exception reports, that are submitted through the portal will be accessible
 
This enhancement extends this practice location reconciliation functionality to plans who have been unable to implement the API.

Updated Domain Table Lists for Hospitals and Specialty Boards

There are now updated domain table lists for hospitals and specialty boards.
 
The updated domain table document is available on the resources page.

 

CAQH Solutions Release for October 21, 2019

A National Provider Identifier is Required

In our continued focus on data accuracy, providers are now required to enter a valid Type 1 individual National Provider Identifier (NPI 1) into their CAQH ProView profile. Providers were previously encouraged to enter a valid NPI 1, but were not required to and were able to save an invalid individual NPI 1. 

With this release, only a valid individual NPI 1 entered into the system is accepted. If the NPI 1 entered is invalid, providers will not be able to attest. 

What to know: 

  • A valid NPI 1 means that the provider's name and individual NPI 1 entered in CAQH ProView matches the information in the National Plan and Provider Enumerations System (NPPES) Registry.
  • An individual NPI 1 that is captured in the participating organization (PO) outputs, beginning with attestations on October 21, 2019 will be valid. 
  • Providers who have not obtained or do not have an individual NPI 1 for other reasons are able to make a notation on the Personal Information screen. Providers who have an invalid NPI 1 saved in CAQH ProView today will need to correct the information during their next re-attestation.
Updates to Several Domain Tables 

With this release, new values have been added to the State, Lanugage and PLI Carrier Name domain table lists. Participating Organizations have access to the updated domain table document on the CAQH ProView Participating Organization Resources page. 

CAQH ProView Update Notifications to Practice Managers

Updated language has been appended to the CAQH ProView application alerting providers to the new valid NPI 1 requirement. 

 

CAQH Solutions Release for August 12, 2019

CAQH ProView 

New Version (3.0) of CAQH ProView Credentialing API 

The Credentialing API was expanded to allow healthcare orgnaizations to access more CAQH ProView data through the channel: 

  • Other Hospital Name Information 
  • Taxonomy Codes (that correspond to the National Uniform Claim Committee (NUCC) Specialties selected by the provider) 

Healthcare organizations using older versions of the Credentialing API may continue to do so while their teams work to move the new version. This improvement empowers organizations to decide which version of the API they want to use based on the values they wish to receive. The version 3.0 API documentation can be found in the participating organization portal. 

Coming Up: Enforce NPI 1 Validation 

Requiring providers to enter a valid National Provider Identifier (NPI) will improve provider matching during the rostering process and ensure organizations can access to the most accurate provider information. 

This update will require all providers to enter an NPI 1, which is validated against National Plan and Provider Enumeration System (NPPES). For the provider to attest, the following fields much match: 

CAQH ProView   NPPES
NPI 1 = NPI 1
First Name or Other First Name = First Name 
Last Name or Other Last Name  = Last Name 

 

 

 

 

To decrease abrasion and ensure providers have the support they need available, the NPI 1 requirement will be phased-in over time. 

CAQH ProView for Groups 

Pending Provider Group Subscriptions 

Pending provider group subscriptions are now displayed separately from authorized provider groups. If a participating organization has not subscribed to the provider group data, and the provider has granted authorization to the participating organization, a new section within the Group Subscriptions page titled "Pending Subscription" displays. The participating organization user has the option to subscribe to the provider group data.

Updated Email Notifications 

In the past, participating organizations could select one email address to receive a notification when a provider group submits a roster. Now all participating organization users receive an email when a health plan subscribes to a new provider group roster. 

Note: Only the participating organization user who originally set up roster notifications are opted in. Additional plan users looking to receive the email notifications need to log in and opt in separately. 

VeriFide 

VeriFide Search

The new VeriFide search feature gives users the ability to search for VeriFide PSV Orders that require a variety of criteria. Clicking on VeriFide Search from the landing page takes users to a page where one or more search criteria can be specified. The search results are displayed in card form. Each card contains a link to the PSV Order Tracker (released in May), which includes additional Order details.  

New Landing Page and Resources 

When participating organizations log into the CAQH ProView portal and click on "VeriFide" in the menu, the user is directed to a landing page that displays a series of cards representing different portal features. A Resources card has been added that allows users to access current versions of the VeriFide Business Users' Reference Guide and the VeriFide Data Exchange Guidelines directly from within the application. Updated documentation for this release is available within the portal. 

Dynamic Scaling

VeriFide is used by health plans of all sizes, ranging from large national health plans to small specialized health plans. The previously released Normal Re-creds Status chart now automatically scales based on Order volume. The columns in the respective chart will always scale up or down to be visible no matter the volume size. 

 

CAQH ProView Release for July 15, 2019

DirectAssure Portal - Location Reconciliation Reports   

Participating organizations subscribed to the enhanced version of DirectAssure will now be able to view, filter and download reports on locations they have submitted for reconciliation. This capability provides graphical reports to business users and analysts, demonstrating the level of data clean-up performed by the solution. In addition, users can download detailed data on location reconciliation results directly from the portal in CSV format, allowing for easy access to actionable data that will increase directory accuracy.

 

 

Option to Indicate if Practice Location is a Duplicate

Providers will be required to indicate a reason for removing a duplicate address. A dropdown list chronicling commonly voiced explanations will be made available for the provider to select. This update allows for better categorization and improved accuracy of the information that is being captured.  

DirectAssure subscribers will not receive a reason code in the DirectAssure Extracts API whenever a provider rejects or archives a location record.  

 
Using Machine Learning to Enhance the Attestation Workflow

CAQH ProView is deploying an in-app feature that will better reveal instances where there is a high likelihood of incorrect information, specifically regarding provider practice locations.  

Leveraging user engagement to train new models in improving predictions in the accuracy of data, health plans will now have greater confidence that the location information available to populate their directories has been thoroughly reviewed by both our machine learning algorithm and the provider. 

CAQH ProView users will begin seeing the new workflow by October 2019.  

 
Improved Workflow and PO Box Restrictions in CAQH ProView Practice Locations Section

Sections of the Practice Location module were merged to improve the user experience and decrease the number of steps required to add or update a location.  

This enhancement also introduces logic, based on the affiliation question, that offers providers the option to enter a PO box if they do not treat patients at the physical location.
 
This update will improve the practice location workflow experience for providers and improve directory accuracy by ensuring more accurate physical locations are able to be published. 

 

 

Up Next

Enforce NPI 1 Validation 

For the August 2019 release, requiring providers to enter a valid National Provider Identifier (NPI) will improve provider matching during the rostering process and ensure POs are able to access the most accurate provider information. 

This update will require all providers to enter an NPI 1, which is validated against National Plan and Provider Enumeration (NPPES). For the provider to attest, the following fields must match: 

CAQH ProView

 

NPPES

NPI 1 

=

NPI 1

First Name or Other First Name

=

First Name 

Last Name or Other Last Name

=

Last Name 

 

To decrease abrasion and ensure providers have the support they need available, the NPI 1 requirement will be rolled out to providers over time. 

 
New Version of Credentialing API

To allow for greater flexibility, CAQH will be versioning the Credentialing API and adding values to the August release. The new values will be "Other Hospital Name" and Taxonomy Codes, which correspond to the National Uniform Claim Committee (NUCC) Specialties selected by the provider.

 

CAQH ProView Release for February 4, 2019

Improved In-Portal Broadcast Communications for Providers

To ensure providers are receiving timely CAQH ProView communications, the in-portal message banner is being enhanced, and will appear at the top of every screen that is accessed.

A View More will provide a detailed account of the communication.

All active messages targeted to the provider will display on this screen for up to a year or until CAQH removes the message.

 
Social Security Number Validation

CAQH ProView will perform real time validation on the data entered into the Social Security Number field to ensure that the data entered is in the correct format and that the value is unique.

  • Area numbers (first three digits) cannot begin with 8 or 9 and cannot be 666 or 000.
  • Group numbers (middle two digits) must have a group range from 01-99.
  • Serial numbers (final four digits) must have a serial number range from 0001-9999.
  • Letters, spaces and special characters are not permitted.

Providers who have previously saved a Social Security Number in their profile that does not comply with the validation rules, will see a notification on the Correct Errors page indicating that the value must be corrected before the next attestation.

Updated Hospital Domain List

The hospitals domain list will be updated to reflect the American Hospital Association values.

  • Providers’ previously selected hospitals will be replaced with the American Hospital Association equivalent, where applicable.

  • Providers creating a new hospital affiliation record will select from one of the values in the American Hospital Association list.
  • The address that the American Hospital Association has associated with the hospital will display and save in the provider’s profile as read-only.
  • If providers do not see the desired hospital in the drop-down list, they can select the value of Other from the list and then enter the hospital’s name in the Other Hospital Name field.

  • The previously selected values that do not map to the American Hospital Association list will see their hospital name listed in the Other Hospital Name field.

  • Providers will be required to review their updated hospital affiliations selections on the Correct Errors screen before their next attestion.

Later this month, participating organizations will receive the new American Hospital Association values in all extracts.

Also, the DirectAssure JSON API will be populated with the Other Hospital Name outputs during this release.

Participating organizations will receive the Other Hospital Name outputs for CAQH ProView ASCII and XML extracts during the March release

The following information will be available on the Participating Organization resources page.

  • An updated hospitals domain table list with the American Hospital Association values.
  • A crosswalk list illustrating how the current information maps to new values.
  • An updated extract and API documentation illustrating how the field Other Hospital Name can be consumed in the outputs.

NOTE:  Participating Organizations should be prepared for an increased number of profile updates as providers attest to the updated values. 

 
Updated Massachusetts and Oklahoma State Forms

Mapping updates will be made to the Massachusetts form to ensure that existing portal profile fields map to the replica.

 

 

CAQH ProView Release for December 10, 2018

The Tax Identification Field in the Illinois Application has been Updated

Illinois providers will no longer see the Business Arrangement section of the Practice Locations profile.

On the Illinois replica, the Business Arrangement section will populate with the provider’s Tax Identification Number(s) entered in the Practice Location wizard.

 
The Military Only Practice Value has been Expanded

The Military Only practice value has been expanded to include Federal providers.

 
Military/Federal Only Providers Are No Longer Required to Enter a Provider License in Each Practice State

Military and other providers who practice in federally managed practices are not always required to maintain a valid license in the state in which they practice.

To that end, if a provider selects the Practice Setting value Military/Federal Only, the provider will need to provide a single valid license from any state.

The Documents screen will continue to display a License slot for each of their practice states.

  • A provider’s license document will be approved even if the state in which the slot is labeled is different from the state that issued the license.
  • If a provider practices in several states, a License document slot may generate for every state that require an entry however, a copy of a single license will meet the document upload requirement.

Help copy will be added to the Personal Information screen to assist providers with the Military/Federal Only update.

 
Additional Visa Questions were Added to the Personal Information Screen for Massachusetts Providers to Better Align with the States Credentialing Application

In the Work Permit section of the Personal Information screen, new copy is displayed to assist providers in understanding the updates.

Two new optional questions were added to the section:

  • Are you a sponsor?
  • Do you hold permanent immigrant status in the US?

Provider data elements will be mapped to the Massachusetts replica in the January 2019 release.

 

 

 

CAQH ProView Release for October 22, 2018

DirectAssure 2.0 JSON Output Incudes Additional Provier Responses: Cultural Competency, Accessibility, and Special Experience, Skill and Training

To assist health plans in meeting federal provider directory data requirements, additional fields have been added to the provider portal:

  • Cultural competency – Providers are asked if they have completed a cultural competency training.
  • Special experience, skills and training – Providers can indicate their experience in a predefined list of special interests.
  • Accessibility details – Providers can select specific accessibility values for each of their practice locations.

Providers Have the Ability to Update Their Name

Providers who need to update their name (i.e., marriage, divorce, etc.) can do so after they attest for the first time.  As a security measure, the provider will need to confirm that the updated name corresponds to the Social Security Name and date of birth saved in the profile.

Providers Are Required to Create Secure Passwords

To comply with recent security standards, providers are required to create more secure passwords.

 

CAQH ProView Release for September 24, 2018

New Fields Added: Cultural Competency, Accessibility, and Special Experience, Skills and Training

To assist health plans in meeting federal provider directory data requirements, additional fields have been added to the provider portal:

  • Cultural competency – Providers are asked if they have completed a cultural competency training.
  • Special experience, skills and training – Providers can indicate their experience in a predefined list of special interests.
  • Accessibility details – Providers can select specific accessibility values for each of their practice locations.

Providers who practice in states that use the CAQH application will be required to offer a disclosure explanation if they answer “Yes” to a disclosure question.

For providers who have previously attested, this requirement will be enforced during their next re-attestation.

 

CAQH ProView Release for August 20, 2018

New Domain Table Value Added to the Hospitals List

To encourage providers to select a hospital from the drop-down menu before manually entering a name, the "Other (Not Listed)" checkbox was removed from its current location, and instead "Other" was added at the end of the hospital list.  

Participating organizations receive the output in the Hospital Name Field for Admitting Privileges, Admitting Arrangements, and Non-Admitting Affiliations.

New Field Added to Hospital Affiliations

When a provider selects "Other", a new field titled Other Hospital Name displays, and the provider can manually enter their information there.  

The captured information is housed in the Provider Data Summary of the Hospitals Affiliations Section.

In the ASCII/XML extracts, the DA 2.0 JSON extract, and the credentialing API, the Hospital Name field contains “Other” instead of the custom hospital name.

Domain Table Update

The following modification was made to the domain table:

  • The addition of the “Other” value to the hospital name dropdown listing. 

 

CAQH ProView Release for July 23, 2018

Limited Data is Displayed for Retired and Deceased Healthcare Providers 

Data summaries, replicas, activity logs and documents for deceased and retired providers are no longer reported. 

Providers Cannot Delete Approved AAR and PLI Documents

Once an Authorization, Attestation, and Release Form (AAR) or Professional Liability Insurance (PLI) document is approved, providers are no longer allowed to edit or delete the document.

The AAR signature is updated with each attestation. 

If the provider wishes to update a PLI document, he/she should Renew their PLI policy record in the profile which generates a new PLI slot where the new file can be uploaded.

No Updates Allowed to Social Security Numbers or Dates of Birth 

To improve data quality and accuracy, the provider Social Security number and date of birth are no longer editable after their first attestation. 

Updated Oklahoma Disclosure Questions

The disclosure questions in the CAQH ProView portal mirror the questions in the state application. 

Updated Minnesota Application -  Practice Locations

To comply with the Minnesota state credentialing application, providers need to indicate if they are accepting new patients into their practice.

 

CAQH ProView Release for June 11, 2018

North Carolina Providers are Required to Submit Heath Plan Specific Release Forms

North Carolina providers are required to upload a release form for each health plan with which they are rostered.

Participating organizations can retrieve their plan specific release form by visiting the providers documents page in the CAQH ProView portal or, by requesting supporting documents with replicas in the extracts.

NOTE:  If you request the supporting documents with the replicas in the extracts, you will receive release forms for every health plan the provider has uploaded.  Please disregard the information that is not specific to your plan.

Illinois Providers are Required to Enter Tax Identification Information

The Practice Location Tax Identification number field is required for Illinois providers.  Information entered in this field appears in the data summary and in the extracts, but will not map to the replica.

Note: Currently, the Illinois replica imports the tax identification information from the Business Arrangement section of the profile. The Business Arrangement section will be retired in an upcoming release to prevent providers from entering Tax ID information in both places.

 
Updated Georgia Application

The Georgia credentialing application for providers is updated to reflect the current version.

Deceased and Retired Statuses for Providers are Separated on the Return Roster

The Return Roster now notes if the provider is retired or deceased.

Scheduling Duplicate Standard and Custom Extracts is Prohibited

To prevent redundant processing, participating organizations are prevented from creating an extract that has the same file name or format, frequency, filter, criteria and requested section.

Providers are Required to Reset their Passwords after Five Failed Attempts
Providers who have failed five failed password attempts are directed to reset the information
 

 

 

CAQH ProView Release for April 16, 2018

Improving Authorization Workflow

The Authorization Setting for providers now includes an option for individual and global authorization. 

Providers no longer need to authorize access each time they are re-rostered. Authorizations saved in CAQH ProView prior to April 2018 will be mapped to the new configuration.

On this screen, providers choose their authorization setting, “yes” and “recommended" will be highlighted by default.  After the provider selects the Save button, the authorization will be set.

Providers who select global authorization will have the ability to view the health plans that have access to their data.

When a provider elects individual authorization, they will see the health plans that have requested access to their information.

Participating organizations will now see a green checkmark next to “Authorized by Provider” when the provider is in the de-rostered state.

 
Adding Plan Provider ID to Provider Quick Search Page

The Quick Search screen contains a Plan Provider ID field to assist plans in linking their proprietary identifier to the provider record.  

 

Updating the Provider Directory Outreach Email

To improve engagement and reduce provider abrasion, the outreach compliance email better highlights the call to action.

The updated email emphasizes:

  • Providers are not required to attest every 90-days.
  • CMS requires health plans to remind providers to review profile to ensure accuracy. 
  • If nothing has changed since their last attestation, the provider does not need to take additional action.
  • Stress the importance of supplying updated information for accurate provider directories.

 
Clarifying Practice Office Hours

The Practice Location section of the provider profile contains clarifying instructions to ensure the respondent is listing practice office hours. 

 
Domain Table Updates 

This release has modified and introduced values to the following domain tables: 

 

 

 

 

CAQH ProView Release for February 20, 2018

Colorado Application Update

The CAQH ProView state application for Colorado reflects the December 2017 version.

Colorado disclosure question “C” reflects the following:

  1. Have you ever involuntarily resigned, terminated, or surrendered medical staff privileges or employment from a hospital, group practice or other health care facility or medical staff?

  2. Have you ever voluntarily resigned, terminated, or surrendered medical staff privileges or employment from a hospital, group practice or other health care facility or medical staff to avoid disciplinary action or investigation, or while under investigation or while such an investigation is/was pending?  If the provider answers “Yes,” a date is required.

New fields will be added to the Professional Liability Insurance section:

  • Claims History Contact
  • Claims History Fax Number
  • Claims History E-mail
Massachusetts Application Update

Providers practicing in Massachusetts are required to enter tax identification in CAQH ProView.

XML Extract

The description field label in the XML extract for disclosure question #26 has been updated to reflect the following:

Replicated Applications and Supporting Documents

Organizations have the ability to select specific approved documents they wish to include when downloading replicated applications. 

 

Domain Table Update

The following modifications have been made to the domain table:

  • The National Board of Osteopathic Physicians and Surgeons is now included. 
  • Associate Type Description and Address Type Description lists have been added to the table.
Provider Training

Providers indicating that they have interned, fulfilled a residency, or participated in a fellowship are required to enter relevant data about each opportunity.

 

CAQH ProView Release for January 22, 2018

Updating Profile Email Address

Providers have the ability to retrieve their password by following the retrieval prompts.

  

 

As a security measure, the user must provide specific profile information before a password reset link is dispatched.

 

 

Users also have the ability to update their email address. 

 

 

 

 

CAQH ProView Release for December 4, 2017

Participation Tab

To aid in the attestation process, “I don’t know” has been added as an option for providers who are unable to confirm specific health plan participation.

 

Live Chat

For participating organizations requiring assistance, a Live Chat icon has been added to the CAQH ProView menu bar.

 

Time-out Progression

Dentists who have exceeded the time limit to complete their provider profile are reverted to the American Dental Association (ADA) login screen. 

License Migration

The state license and related expiration date for dentists who do not have an existing CAQH ProView account are migrated from their ADA profile to CAQH ProView.

 

CAQH ProView Release for October 30, 2017

DirectAssure Enhancements

Prompted by a series of alerts, providers are asked to reconcile discrepancies found between their self-reported data and the information that is supplied by plans that participate in DirectAssure.  

No action is required from the plans as a result of these enhancements, however the extracts your plan receives may be larger due to increased information.  

Daily Extracts

Rostering and attested information that concludes by 9 pm EDT is included in the current day’s extract; custom extracts remain unchanged.  

Review and Attest Screen Consolidation

To improve the user experience, the review and attestation screens have been consolidated.  

Application Release Documents

Pursuant to state requirements, Oklahoma providers are required to upload the CAQH and Oklahoma application release documents.  

Conditional Employment Gap

For the following states, providers are reminded to explain gaps in employment that are less than the current requirement of 6-months:

  • Colorado, Georgia, Illinois and Oklahoma – 30 days.
  • Oregon - 60 days 
  • North Carolina and West Virginia – 90 days.
Removal of Group Number Field from the Practice Locations Section for Providers

To eliminate duplicity, the Group Number field has been removed for Texas providers as it mirrors the information housed within the Organizational (Type 2) NPI field.

 

CAQH ProView Release for September 25, 2017

Updates to CAQH ProView Domain Tables

Significant updates will be made to the domain table.  See below for a detailed listing.

Countries

The following Country list values will change:

Country – Current Value

Changed to Value

East Timor (provisional)

East Timor

Wallis and Fortuna Islands

Wallis and Futuna

Western Sahara (provisional)

Western Sahara

Guadaloupe ->

Guadeloupe

 

The following values will be added to the Country listing:

Added Value

Palestinian Territory

West Bank

Gaza Strip

Serbia

Montenegro

Kosovo

Guernsey

Jersey

Isle of Man

Saint Barthelemy

 

Institutions

The following values will be added to the Institution listing:

Added Value

Arizona School of Dentistry and Oral Health

East Carolina University School of Dental Medicine

The Dental College of Georgia at Augusta University

LECOM College of Dental Medicine

Midwestern University College of Dental Medicine - Arizona

Midwestern University College of Dental Medicine - Illinois

Missouri School of Dentistry and Oral Health

Roseman University of Health Sciences College of Dental Medicine

Rutgers School od Dental Medicine

Touro College of Dental Medicine at New York Medical College

University of Nevada, Las Vegas School of Dental Medicine

University of New England College of Dental Medicine

University of Utah School of Dentistry

Western University of Health Sciences College of Dental Medicine

 

Languages

The following Language list values will change:

Language – Current Value

Change

Byelorussian

Belarusian

Laothian

Lao

Latvian; Lettish

Latvian

 

The following values will be added to the Languages listing:

Added Value

Bosnian

Cantonese

Cebuano

Chechen

Egyptian Arabic

Filipino

Flemish

Haitian Creole

Hakka

IIokano

Iu Mein

Jamaican Patois

Khmer

Lombard

Maung

Min

Scots

Taiwanese

Tulu

 

State and Territories

The following values will be added to the State listing:

Added Value

Federated States of Micronesia

Marshall Islands

Northern Mariana Islands

Palau

 

 

CAQH ProView Release for August 28, 2017

Updates to CAQH ProView Domain Tables

The value “American Academy of Physician Assistants” has been removed from the Certifying Board list for Physician Assistants. Providers are instructed to select a new value for “Name of Certifying Board” before their next attestation.

Update to Gender Limitation Values Mapping in ASCII and XML Extracts

The mapping for provider-selected values in Practice Location Gender Limitations to ASCII and XML extracts have been updated to deliver the provider’s response.

  • The value “Not Applicable” displays in extracts for providers who answer:
    •  “No” to “Do you have gender limitations?” OR
    • “Yes” to “Do you have gender limitations?” and also respond to “Gender Limitation Type” by selecting “None” or “N/A.”  
  • The value “Male Only” displays in extracts for providers who answer:
    •  “Yes” to “Do you have gender limitations,” and who respond to “Gender Limitation Type” by selecting “Male Only.”
  • The value “Female Only” displays in extracts for providers who answer:
    •  “Yes” to “Do you have gender limitations” and who respond to “Gender Limitation Type” by selecting “Female Only.”

Please review the Sample Gender Limitations Mapping.  

Hospital State and Zip Codes Now Appear in Provider Data Summary

State and Zip Code data display for Hospital Admitting Privilege records in the Participating Organization view of the Provider Data Summary.

Type: 
Audience: 
Organization Type: 
CAQH Program: