- 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
Dental Plan FAQs
What is CAQH ProView?
CAQH ProView is an online provider data solution. It streamlines provider data collection, maintenance and sharing by using a standard electronic form that meets the needs of nearly every health and dental plan, hospital, provider group and other healthcare organization.
CAQH ProView enables dentists, physicians and other healthcare professionals in all 50 states, the District of Columbia and U.S. territories to enter information free-of-charge into a secure central database and authorize healthcare organizations to access that information. CAQH ProView eliminates redundant paperwork and reduces administrative burden.
How does this service make it easier for dentists to credential with my dental plan?
In two important ways: First, once a dentist completes their CAQH ProView profile, it can be shared with any participating dental plan, eliminating the need to fill out duplicative credentialing applications for each plan.
Second, any U.S. practicing dentist can participate in this service by logging into ADA.org/godigital, clicking on “My Credential” and accepting the terms and conditions. They will be redirected to CAQH ProView, where specific information from the ADA has been automatically entered into their credentialing application - making it easier and quicker for the dentist to complete and attest.
How does CAQH ProView ensure that dentists keep their information up-to-date?
Dentists can update their information any time their practice or professional data changes. Automatic reminders also encourage dentists to review and attest to their information every 120 days so that their CAQH ProView profiles remain timely and accurate. The system will also prompt users if their licenses or other documentation is about to expire.
What types of organizations are able to access dentist data in CAQH ProView?
Every dental and health plan may use CAQH ProView if they choose to participate. Other healthcare organizations that handle credentialing functions on behalf of dental or health plans – or that have their own need for credentialing – may also use the solution. However, in all cases, healthcare providers must submit authorization for the organizations they choose to have access to their information.
Can organizations other than dental plans participate in CAQH ProView?
Yes. Over 900 organizations currently participate in CAQH ProView, including health plans, third party administrators, hospitals, health systems and provider groups-practices.
Does it cost anything to use CAQH ProView?
There is no cost for dentists or other healthcare providers to use CAQH ProView. Dental plans and other healthcare organizations using CAQH ProView pay administrative fees and an annual fee per provider to access the solution.
Does the provider data profile created in CAQH ProView meet the NCQA requirements for credentialing application content in CR3, Element C?
Yes, the NCQA website clarifies that CAQH ProView system data meets the requirement in CR3, Element C, and is acceptable in either electronic or PDF format. There is no automatic credit for the application. NCQA reviews CAQH ProView output against the appropriate elements.