Missing licensure and board certification details
Toward the end of your profile is a place to upload relevant documents. This includes state licenses or specialty board certifications. These proofs aren't enough for the CAQH profile, however. Specific information, such as expiration dates and board exam details, should be entered as well. Professional license information is within the Professional IDs section. The board certification information is listed in the “Specialities” tab. Make sure your information is listed here and that it matches any related documentation uploads to avoid credentialing delays.
Incorrect information
Getting every detail right in each section can make or break your credentialing process. You'd think getting the details right would be straightforward, but I’ve noticed that small oversights can create bigger delays down the road. When you're being credentialed with an insurance company or through a credentialing service like Headway, all of the information should be accurate. Otherwise, it will get flagged. Examples of things that can easily be missed are your specialty and taxonomy code. Your taxonomy code is related to your NPI number in the NPPES system and typically they should match exactly. The final review step in CAQH can catch some missing items, but it's up to you to ensure there are no input errors.
Inaccurate liability insurance coverage limits
Liability insurance information is one of the most common snares for mistakes. Under the “Professional Liability Insurance” section, there’s an area that asks for coverage amounts. One box says “Amount of Coverage Per Occurrence” and the other says “Amount of Coverage Aggregate.” Amounts may vary depending on the policy you have; for example, $1,000,000 and $3,000,000 in these respective boxes. The common error in this section is not having the correct number of zeros. You might make the amount far too small or large by adding or leaving out a zero. Verify that these numbers are correct — and make sure they match the numbers on your insurance policy document.
Inactive liability insurance policy
When Headway or an insurance company is processing a credentialing application, they go to CAQH to look at your information. Active liability insurance is a key aspect that the system is looking for. If you have no insurance policy, or if your previous policy has lapsed, this will be flagged in the CAQH system and will bring the credentialing to a halt. When you're creating or attesting your CAQH profile, verify that your insurance policy is up to date and active. If you see an approaching expiration date, make a point to renew the policy and update the information in your profile.
Missing liability insurance policy document
Even if you manually input all the correct information in your profile, there are still documents that need to be uploaded at the end of the process. That includes your liability insurance policy. If the requested documents aren't provided, it can lead to an application rejection or slower processing times. Based on what I’ve observed and heard from other providers, providing the supporting documentation can really help prevent delays. You should upload a document, typically a PDF, that includes the major details of your policy such as policy number, expiration date, specific details of the plan, and coverage limits. This can be provided to you by your insurance provider if you don't have a copy.
Incorrect policy listed (employer vs. personal)
There are liability insurance policies for individuals and policies for employers. Since the CAQH is intended for individual providers, your profile should reflect your individual liability insurance. Even if you have insurance under another employer, CAQH will be looking for a policy for you as an individual provider. Since Headway and other insurers credential you as an individual provider, they want to see your individual coverage. If this is not included in your profile, it can delay or interrupt your credentialing process.
Failure to save and attest
CAQH does not have an autosave feature as you progress through building your profile. At the bottom of each section is a “Save” and a “Save & Continue” that should be clicked to save the information you have entered on that page. Forgetting to save can lose data you have entered, become a setback in the process, or leave you with unfinished sections.
The final step of the CAQH profile is attestation. This submission to have the system verify your profile is crucial but is surprisingly easy to miss, especially if you’re rushing through. Your credentialing process may be delayed if you don't “attest” at the end of your profile. Make a note or do whatever you can to remind yourself to save and attest.
