Everything You Need To Know About CAQH UPD

Payor Enrollment, Provider Relations, Provider Credentialing, CAHQWhile striving to provide adequate healthcare for every American, the Patient Protection and Affordable Care Act's (PPACA) has created a minefield of potential problems for the healthcare providers, themselves. There are almost innumerable new laws, regulations and paperwork requirements that must be met in order to remain in proper compliance. The task is indeed daunting especially when one’s priorities lie within the realm of actual patient care.

CAQH UPD

One of the most effective ways to accomplish this goal is to have all your providers enroll in the Council for Affordable Quality Healthcare’s (CAQH) Universal Provider Datasource (UPD). The UPD provides one standardized electronic form and a single secure database. Designed from the ground up to meet the needs of healthcare facilities, the UPD is an essential tool in 21st healthcare management.

The electronic form significantly facilitates the submitting, updating and accessing of healthcare information and provides un-rivalled  security and patient confidentiality. In addition, the transfer of information between healthcare entities is made easier and far more dependable.

Benefits for Payors and Providers

The benefits of enrollment in the UPD are many as the system is designed to facilitate the exchange of information between all of the interested parties. Indeed, as compared to UPD enrolled entities, the actual paperwork is reduced as multiple forms are populated from all data as it enters the system. In addition, revenues are maximized and streamlined as far fewer clams are denied and extremely specific reasons are detailed for the ones that are. Most importantly, the healthcare providers, themselves, can focus on what they do best; provide superior care to their patients.

The Enrollment Process

Actual enrollment in the UPD is quite simple. A provider or organization acting on behalf of a provider must contact a participating organization to initiate securing a CAQH ID or Contact the CAQH Support Desk at 1-888-599-1771 to secure additional instructions. Once registered, a CAQH invitation package will be mailed to you. Upon receipt of this invitation package, you can then register in the UPD using the credentials provided, complete the UPD Online Form, Authorize UPD- participating Plan Access to your information, verify data entered and submit required documentation.

Why All the Fuss?

Over one million individual healthcare providers as well as all major hospitals, health plans and healthcare facilities use the UPD and demand the same of their potential vendors, partners and referrers. It is simply impossible to be successful in the 21st century healthcare industry without harnessing and utilizing this type of electronic media when it is the same information requested and required by multiple organizations . Enrollment is not particularly difficult, but it does take some time, perseverance and knowledge. Be sure that all your providers are enrolled in this key database.

Provider Credentialing


Tisha Rader

About the Author
Tisha Rader

With a background that includes 21 years in healthcare, Tisha has extensive experience in healthcare management, credentialing, billing and collections, physician practice start-ups, and patient care. Formerly, Mrs. Rader was one of Community Health System’s Director of Physicians Practices at CHS owned hospital, Heritage Medical Center. In addition, Tisha held a position as part of the hospital administration/key management team at Heritage Medical Center . Additionally, Mrs. Rader received the President’s award at CHS. She previously owned her own billing and consulting company. Tisha holds an M.B.A from Bethel University in McKenzie, TN.

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