PSA for New Medical School Graduates and Payer Enrollment:First Step

Without a CAQH profile, commercial payers will not enroll you in health plans and you will not get paid – simple. The No Surprise Bill Act makes CAQH profile accurate and attested every 120 days. CAQH (Council for Affordable Quality Healthcare) is important because it plays a central role in streamlining the credentialing and enrollment process for healthcare providers in the U.S. CAQH ProView is integral for new healthcare professionals as it ensures that they can navigate the complex insurance landscape efficiently. A well-maintained CAQH profile not only facilitates smoother operations but also enhances the likelihood of successful enrollment in various health plans, which is vital for establishing a functioning practice.

As we approach residency match day 2026, understanding these processes becomes even more critical for new graduates preparing for their future in the medical field.

As we prepare for residency match day 2026, understanding these processes becomes even more critical for new graduates entering residency programs.

Centralized Provider Data Repository

CAQH offers the CAQH ProView platform, which is a standardized, centralized
database where healthcare providers input their professional and practice information.
Payers (insurance companies, hospitals, etc.) then access this data for credentialing
and network enrollment purposes.

Simplifies Credentialing

Without CAQH, providers would have to fill out separate credentialing forms for each
payer, which is time-consuming and redundant. CAQH allows them to enter their info
once, then authorize multiple organizations to view it—saving time and reducing errors.

Required by Most Payers

Many major commercial insurance companies require a provider to have an up-to-date
CAQH profile to even start the enrollment process. It’s often the first step after getting
licensed.

Supports Re-attestation

CAQH requires providers to attest that their information is correct every 120 days. This
helps ensure that payers always have the most accurate, up-to-date information,
reducing delays in claims processing or credentialing issues.

Helps with Delegated Credentialing

For organizations handling credentialing on behalf of multiple providers, CAQH is a
standard tool. It helps practices and billing companies manage large volumes of data
more efficiently.

CAQH ProView Setup Checklist

Before You Start

• NPI Number (National Provider Identifier)
• State Medical License(s)
• Professional Liability Insurance Info (aka malpractice)
• DEA Registration (if applicable)
• Practice Location Details (address, phone, contact)
• Work History (past 5 years) – no gaps over 30 days
• Education & Training Info (schools, residencies, fellowships)
• Board Certification Info
• Hospital Affiliations
• Photo ID (usually driver’s license or passport)
• CV/Resume (current with MM/YYYY format)

Step-by-Step Setup

1. Go to https://proview.caqh.org
2. Create an Account (or wait for payer invitation to register)
3. Complete Profile Sections
   o Demographics, Licensure, Practice Locations, Education, Work History,
   References
4. Upload Documents
   o Licenses, DEA, malpractice cert, photo ID, etc.
5. Attest to your information
   o This confirms all info is accurate (required every 120 days)
6. Authorize Payers to access your profile
   o Search and add the insurers you plan to work with

Ongoing Maintenance