CAQH SET UP INSTRUCTIONS

The CAQH application is in three parts and will take you about 90 minutes to complete. Only fill out required sections that have a red asterisk unless otherwise indicated below. 

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DESCRIPTION OF CAQH

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PART ONE

Go here: https://proview.caqh.org/PR/Registration 

Scroll to the bottom and click “Go to next section.” Fill out the form as best you can. 

PART ONE is one page, will assign you a CAQH provider number when you are done, and will take about ten minutes. 

TIPS FOR PART ONE:

  • If you are an IBCLC  or CLC and that is your highest level of credential, for the first question in Part 1 (NUCC Grouping), select “Other Service Providers,” and for the next question (Provider type), select “Provider type not listed.”
  • If you are an RN, FNP, PA, CNM or similarly licensed provider, please use that as your primary credential and fill in that information here. For NUCC Grouping, select “Nursing Service Providers,” and for the next question (Provider type), select the nursing license that you have. There will be a place in part 3 of the application to add your IBCLC credential as your second credential.
  • When asked for your license if you are an IBCLC or CLC in a state that does not offer licensure, select your state and put in your L- number / IBCLC certification number or or ALPP-number.
  • When asked for your address type, select “home” and write in your home address.
  • When they ask for a DEA number, check off “I do not have a DEA Number.”

You will then receive an email called “Provider Registration” that will state: “To register, log on to Link.” The word “Link” will have a hyperlink that will take you back to CAQH. A provider ID will already be in the form for you. Take note of the provider ID for your records. Click “continue.” A pop up will show up that is called “Getting Started”; scroll to the bottom and click “Next.”

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PART TWO

PART TWO, the next part of the application, will take you about ten minutes to complete. It will ask you to enter a personal identification number. Please write in either your SSN or NPI; do not fill out all fields, only one of them. On the next screen, set up a username, password, and security questions. Take note of these items because you will need them later. Click “Create Account.” When finished with Part 2, CAQH will state: “Congratulations! Your registration was successful. Please click OK to log into Proview.”

Click the hyperlink – OK.

In the Sign-in section, type in your username and password that you set up during registration.

You will next be brought to PART THREE of the process which is the main part of the application. 

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PART THREE

PART THREE, the final part of the application, will take about an hour to complete. Some of the early questions will be auto-populated with information you already provided to CAQH. Fill out the rest as best you can, but only fill out required sections that have a red asterisk, and it will go faster and be less confusing. 

TIPS FOR PART THREE

  • LICENSE: On the second page of PART THREE, when you see the area that has your license number auto-populated, please choose “edit,” select “yes” for the “Currently Practicing” question, and add in your license/certification expiration date. This section will auto-populate with “PTNL” which means “provider type not listed” which is what you selected in PART ONE.
  • SPECIALTIES: 
    • You should be able to choose “Lactation Consultant”, either RN or non-RN or your other primary specialty. 
    • For “Name of Certifying Board,” choose “other, not listed” if it won’t let you choose “International Board of Lactation Consultant Examiners” or the name of the Board that certified you. 
    • When it asks if you wish to be listed in the directory under this primary specialty, select “yes” for all three policy types.
  • EDUCATION: While not everything is required with a red asterisk, please fill out any degrees/schooling/internships, etc. that you have; listing those will help with some insurance company contract requests. 
  • PRACTICE LOCATIONS: You must add one practice location. Here is a step by step to guide you through this important section.
    • Practice Location Name: this is the name of your company or your name if no company exists
    • Location Address: this is your main work address that will be displayed in insurance directories; it is fine to use your home address if you don’t have an office or would just prefer to use your home address
    • Appointment Phone Number: this is the number you want published in insurance directories when moms search for you
    • Tax ID: if you have a company, use its EIN (employee identification number); if you do not have a company, use your SSN
    • Type of Tax ID: select “individual” if you are the only provider working in your company; select “group” if you work with other providers
    • Hours of Operation: limit what you enter to your official business hours; if you plan to see patients by appointment, such as on Saturday or Sunday, do not include those potential hours
    • Please describe your affiliation with this location: select “I see patients by appointment at least one day per week on a regular basis”
    • Provider’s Start Date: use the date your started your work activity at this location
    • Patients: choose “yes” for everything under “Patients” except “do you accept new patients from physician referrals” where you choose “no.”
  • CREDENTIALING INFO: Anytime a credentialing contact is requested, use Charlotte Stellan, 34 Hill Road, Greenwich, CT 06830, assistant@lactationbilling.com, 203-614-9030 (phone), 310-872-1533 (fax), and check off that this is your primary credentialing contact. For “location type,” select “practice location.” In the new field that shows up for “practice location,” select your company name.
  • EMPLOYMENT INFORMATION: You don’t have to include your whole work history. CAQH is looking for ten years of work history in lactation and wants explanations of gaps in your employment history. If your lactation employment history is less than ten years, only list work history from your initial licensure/certification date as a health professional. 
  • PROFESSIONAL REFERENCES: Add at least two even though there is not a red asterisk. It’s fine to use Nicole as a reference – Nicole Peluso, nicole@lactationbilling.com, 323-595-4006.
  • AUTHORIZATION SETTING: The “Authorize” button is in the top navigation all the way to the right side. Choose “yes” so that insurance companies can view the information in your CAQH profile when they request to view it.
  • DOCUMENTS: The “Documents” button is the third option in the top navigation. Be sure to upload your liability insurance as an attachment in this section, even though you’ve already inputted the data from your liability policy earlier in the application. Sometimes an individual state will request you to sign other documentation. If prompted to do so, please sign and upload that as well.

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REVIEW AND ATTEST

  • REVIEW AND ATTEST: Click the red “Review and Attest” button when you have completed all parts of CAQH.
  • ERRORS: A “Correct Errors” section may come up listing parts of the application that still need to be filled out. Click each one and fill them out.
  • ATTEST: After all errors have been corrected, click the red “Attest” button. You will receive an email confirming your attestation.
  • QUARTERLY ATTESTIONS: CAQH will email you every three months to repeat the review and attestation, update any expired information, or add answers to any new questions they have added. It is important to complete your quarterly attestations on time.
  • ANNUAL LIABILITY INSURANCE REUPLOAD: Each year you will need to re-upload your renewed liability insurance policy. Additionally, you will need to add the new expiration dates to the “Professional Liability Insurance” section.
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