Credentialing Updates!CAQH ProView™ is Coming in February 2015.

The CAQH® Universal Provider Datasource® (UPD) is trusted by more than 1.2 million healthcare providers as the premier resource for self-reporting demographic and professional information to payers, hospitals, large provider groups and health systems.

Now CAQH is significantly improving the UPD to make it more useful and easier to use, reducing the time and resources needed to submit accurate, timely data.  To reflect these improvements, CAQH is changing the name of this next generation UPD to CAQH ProView™.

Launching in February 2015, CAQH ProView will remain free of charge to providers.

Launching in February 2015, CAQH ProView will remain free of charge to providers. New, time-saving features include:

  • Complete and attest to multiple state credentialing applications in one intelligent workflow design.
  • Upload supporting documents directly into CAQH ProView to eliminate the need for manual submission and to improve the timeliness of completed applications.
  • Review and approve Practice Manager information before data is imported.
  • More focused prompts and real-time validation to protect against delays in data processing.
  • Self-register with the system before a health plan initiates the application process.

Prepare Now to Transition to CAQH ProView. To ease the transition to CAQH ProView, CAQH has outlined action items for you to complete. Information about these items is also available here. These tasks are extremely important and will eliminate the need for you to do extra work after CAQH ProView launches.

Action Item #1. Make sure your UPD application is complete.

  • All completed UPD applications with current attestations will automatically migrate into CAQH ProView.
  • If your application is currently incomplete, log into UPD and complete the required information by January 28, 2015.
  • If you do not complete the required information and your attestation by that date, it will not automatically migrate into CAQH ProView, and the entire application will have to be re-entered.

Action Item #2. Complete any updates and re-attestations by January 28, 2015.

  • If you need to update any application information and complete a re-attestation in January 2015, please be aware that the system will be down after January 28 until the system launches in early February.
  • To avoid any disruptions, update your information and complete re-attestation by January 28, 2015.

Action Item #3: Enter your email address in the UPD.

CAQH ProView requires an email address for all users as the primary method of contact.  If you already have an email on file, please login to the UPD and verify that it is the correct one.

Training for CAQH ProView

With its time saving and intuitive features, CAQH ProView will be even easier to use than UPD.  Training resources will include a quick reference guide, a getting started video, and a user manual.  CAQH will notify providers when training materials are available.

Special New Features for Practice Managers CAQH ProView’s improved functionality for practice managers includes a time-saving bulk upload feature.

CAQH has established a CAQH ProView Provider Transition Support Center to help providers and practice managers with the transition.  If you need assistance completing your application, re-attesting or have any questions, please email or call 844-259-5347.

Source:; December 20, 2014.

Practices on TRICARE Civilian Request Forms are changing February 28, 2015

Credentialing Updates!

UnitedHealthcare Military & Veterans recently enhanced the Civilian Referral Request Form used to submit requests for care. The new form has been redesigned to be more user-friendly when requesting care for specialty referrals, outpatient (medical/surgical), inpatient (acute, skilled nursing facility, rehab), and durable medical equipment/home health requests.

The following items were added to make the form easier to use:

  1. Date of Service to the top of the form to indicate desired beginning date of service
  2. Episode of Care (EOC) field to allow specific EOC selection
  3. Benefits Number and Sponsor Social Security Number along with checkboxes to indicate selection
  4. Option to use National Provider Identifier (NPI) or Tax Identification Number (TIN) along with checkboxes to indicate selection
  5. Urgent definition to top of form to indicate when care is needed within 72 hours

We are also implementing a new policy to help ensure timely processing of referral requests to help TRICARE beneficiaries receive the care they need as quickly as possible.

Effective immediately, forms missing information marked “required” will be rejected and faxed back to the provider for correction. To help you transition to the new form, the previous form will continue to be accepted until 02/28/2015. After this date, all referral requests submitted on the outdated form will be rejected with a request to use the new form.

Source:; December 17, 2014.