Council for Affordable Quality Healthcare

The nonprofit alliance of health plans and trade associations that operates CAQH ProView, the universal credentialing database used by most commercial payers in the United States.

CAQH as an organization is the entity behind the ProView system that every provider interacts with during credentialing. The Council for Affordable Quality Healthcare was founded in 2000 as a collaboration between health plans to reduce the administrative burden of credentialing by creating a single data source. Beyond ProView, CAQH operates several other initiatives. CAQH CORE (Committee on Operating Rules for Information Exchange) develops operating rules for electronic administrative transactions. CAQH Explorations researches administrative simplification opportunities. But ProView is what matters most to individual providers. The CAQH ProView database contains credentialing data for over 1.4 million healthcare providers. More than 900 health plans, hospitals, and other organizations use ProView to access provider data for credentialing purposes. When a payer needs to credential you, they pull your data from ProView rather than asking you to fill out their own proprietary application. CAQH ProView is free for providers. The costs are borne by the organizations that access the data. You do not pay anything to create, maintain, or attest your profile. Some providers assume there must be a catch or a premium version, but there is not. It is genuinely free for the provider side. The 120-day attestation requirement exists because CAQH needs to ensure the data is current. Healthcare credentials change: licenses get renewed, insurance policies update, addresses change, new certifications are earned. The regular attestation cycle forces providers to review and update their information. CAQH has been expanding beyond credentialing into other areas of healthcare administration like prior authorization automation and provider directory management. Their goal is to reduce the $400 billion annual cost of healthcare administration in the United States. Whether they succeed remains to be seen, but the ProView system has genuinely made credentialing less painful than it was before 2000.