CAQH Accounts: A Key Ingredient to Faster Credentialing
Credentialing may be your least favorite task as a therapy clinic owner, and we certainly understand why. Especially if you have a large practice, just making sure that your therapists stay credentialed for each insurance company can feel impossible. However, it can be much simpler than having to submit separate applications, with different requirements, to each one. That is if you consider one major factor: CAQH (Council for Affordable Quality Healthcare) membership.
Why Use CAQH for Your Therapy Clinic?
As a therapy credentialing company, we have to be well-versed in the administrative necessities of helping our clients run an efficient and effective business. Given our experience, we would argue that, since the early 2000s, one of those necessities has been applying for and keeping up with CAQH accounts for each therapist who works for you. Think of CAQH as a master key that unlocks the door to efficiently and effectively engaging each insurance company. It’s similar to the Common App for colleges, which allows you to enter your essential data one time in a central portal, plus answer some specific questions for individual schools. It feels far less stressful and takes a lot less time than juggling multiple applications.
As much as it may be a burden that often falls on you and/or your admin team, having and maintaining a CAQH account for each therapy provider on your staff is essential for continuity of care and a healthy revenue cycle.
The Importance of Updating CAQH Accounts for Therapy Providers
Not only will up-to-date CAQH accounts save you the headache of submitting multiple applications, but they come with distinct advantages. Since the world of healthcare is so heavily driven by insurance these days, many prospective patients will narrow their search for a therapist based on which providers are in-network with their insurance. Put simply, the more insurances you’re in-network with, the larger patient pool you have. CAQH makes this not only possible but relatively straightforward. In addition, CAQH users enjoy reduced application processing time and increased data security compared to providers who try to manage unique portals and submissions.
If the benefits of membership are not enough to sway you, there is the fact that CAQH membership is becoming an industry-standard because many insurance companies already require it for providers. It is reasonable, then, to consider offering incentives for CAQH membership for your therapists, or making it mandatory to submit credentials through CAQH for as many insurances as possible.
Perhaps you are already on top of getting a CAQH account for each provider. That brings us to the most common cause of a credentialing delay, in our experience: an account that is not updated and attested. Though this system streamlines the credentialing process, it must be used to its full capacity to be effective. There are variations in each insurance’s specific requirements. Also, all members will receive an email request to re-attest all of the information in their CAQH profile every four months. Neglecting initial alerts that ask for additional information, or ignoring these regular emails, could ultimately cause extensive delays.
What You Will Need for CAQH When You Hire a New Therapist
So, you are requiring CAQH membership for every provider in your clinic. Now, how do you make sure the credentialing process is as stress-free as possible in the long run?
Gather critical documents and personal information from new hires early! Using some of our suggestions for supportive clinic policies may help.
Then, take extra care to double-check that the following items are correct:
- Work history, including an explanation of any gaps
- Practice location and credentialing contact
- Personal data (name, current address, education, etc.)
- Any specialties or board certifications
Often, one of these seemingly minor pieces of data can be the reason that a provider cannot begin treating, and that you cannot begin billing, for a particular insurance company.
Outsource Your Clinic’s CAQH Management
Despite the dramatic difference it makes to have a centralized system for applications and pertinent paperwork, the management of your team’s credentials can still be a huge ongoing task. That is just one of many reasons our team at Clinic Connection has become adept at managing all that’s involved with CAQH accounts. We are here to ease potential frustration for you and your therapists with our customized services.
Contact us to schedule your consultation today!
