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Melissa Outlaw

By: Melissa Outlaw on March 7th, 2016

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The Affordable Care Act: Your Guide to Physician Credentialing Through CAQH ProView

Healthcare Provider Credentialing

The Patient Protection and Affordable Care Act (PPACA) strives to provide healthcare for every American. With it comes new laws, regulations and paperwork requirements that must be met in order to remain in proper compliance. For those healthcare providers who are not familiar with these new standards, it can make adherence a complicated and daunting process.

The use of physician credentialing software can help. We put together the below guide, covering a top line view of the new physician credentialing software, CAQH ProView. Read on to understand what you need to know so you can continue to provide the best patient care possible.

What is CAQH ProViewTM?

By requiring provider enrollment in the Council for Affordable Quality Healthcare’s CAQH ProView (formerly the Universal Provider Datasource®), healthcare payors and participating groups are given easy, streamlined registration of CAQH’s secure database. This means that approved organizations can easily access and review credentialing information, making it a critical part of the credentialing process.

Designed from the ground up to meet the needs of healthcare providers, the CAQH ProView is an essential tool for today's healthcare management. CAQH ProView offers unrivaled security in a dependable, user-friendly, accessible platform, facilitating simple transfer of information between healthcare entities.

Benefits for Payors and Providers

Want to get the most out of the available technology while creating simple and secure exchanges of information between authorized parties? Enrollment in CAQH ProView alongside use of your physician credentialing software will help! It will reduce paperwork, streamline the population of data, and eliminate the potential for the typical errors seen in repetitive manual entry.

Most importantly, registration and use of CAQH ProView combined with physician credentialing software (such as that offered by symplr) helps healthcare providers focus on their main priority - making sure patients receive the superior healthcare they deserve.

The Enrollment Process

Actual enrollment in CAQH ProView is quite simple. Providers (or the organizations acting on their behalf) can complete their CAQH ProView profile online, by visiting the registration page. Check out this quick reference guide for helpful suggestions on preparing for and streamlining profile completion.

Completing the initial CAQH ProView profile may take up to two hours. However, once a profile is complete, ongoing maintenance is easily performed through a streamlined re-attestation process.

Once a provider or organization has completed the CAQH ProView registration and application, users can individually authorize access to their information. This allows those participating in healthcare organizations as affiliated providers (or for whom they are in the process of becoming an affiliated provider) to review their information. This access can be controlled and their approved authorization adjusted at any time.

Why All the Fuss?

CAQH ProView is no small thing. Over one million individual healthcare providers (as well as all major hospitals, health plans and healthcare facilities) use it.[1] And they require that their potential vendors, partners and referrers do the same. Healthcare organizations can and should harness innovative technology to drive success. Connection to CAQH ProView bridges the gap between multiple parties and helps drive credentialing efficiency.

Give your healthcare facility the opportunity to save time, money and effort by completing the provider enrollment in CAQH ProView today. A bit of perseverance now means you can return your attention to providing high-quality patient care.

To learn more about how physician credentialing software can help you take advantage of today's technology contact the experts at symplr today!

[1] CAQH ProView.


About Melissa Outlaw

Melissa Outlaw is a Vice President, Customer Success with symplr. Melissa and her team assist clients in learning and implementing our provider management software - credentialing, privileging, peer review, quality and event reporting applications. She supports clients in benchmarking current internal practices, identifying potential efficiencies, then driving the integration of technology with process improvement to reduce time of service and operating expenses. She works extensively with decentralized, multi-facility organizations in transitioning to a shared service center as well as assisting healthcare organizations bridge the gap between procedures performed by a provider and their privileges granted.