Using CAQH to make the provider credentialing process easier

As part of the contracting process for participation in Pinnacol’s provider network SelectNet, we evaluate physicians and other healthcare providers to confirm providers are adequately trained, certified and/or licensed to provide quality care. The credentialing process includes the collection and verification of data on the provider’s education, training, experience, practice history, location; disclosure of any issues impacting their ability to provide care; and other background information.

The Council for Affordable Quality Healthcare (CAQH) is a nonprofit alliance of more than 140 health plans and related organizations designed to make credentialing easier by gathering data in a single repository accessible to participating plans and organizations. 

CAQH participation can improve data accuracy, reduce administrative burden and costs, streamline businesses processes, and mitigate compliance risks. CAQH participation is available at no charge to providers.

CAQH will serve as Pinnacol’s credentialing verification organization beginning Feb. 1, 2018. More than 80 percent of SelectNet participants already use CAQH to self-report their professional information to major carriers. 

CAQH will make it easier for providers to update their profiles, reducing the time and resources necessary to submit accurate, timely data to Pinnacol. Time-saving features enable healthcare providers to:

  • Complete and attest to multiple credentialing applications in one workflow
  • Upload supporting documents to eliminate the need for manual submission and to improve the timeliness of applications
  • Self-register with CAQH before initiating Pinnacol contracting and credentialing 

Office managers can enter information for multiple providers and eliminate the duplicative paperwork required for claims administration, credentialing, directory services and more. 

To enroll in CAQH, follow these four steps from their website
1.    Register and receive a CAQH ID
2.    Build your provider profile with location and practice information
3.    Upload and submit supporting documents 
4.    Verify and attest to the data

You can authorize the release of your self-reported information to all healthcare organizations or add Pinnacol Assurance to the list of your approved organizations.

For assistance with Pinnacol’s credentialing process, email credentialing@pinnacol.com.