Jogaza Credentialing

CAQH ProView: what nurse practitioners need to do, and how often

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Short answer

  • Most commercial and Medicaid plans pull your credentials from CAQH ProView. Keep it complete, authorize every plan, and attest.
  • Re-attest every 120 days, or plans lose access and applications stall.
  • A credentialing company or group can fill in practice details with a Practice Manager account, but only the clinician can accept them and attest.

What goes in your profile

  • Licenses, DEA, board certification, education and 10 years of work history.
  • Malpractice insurance: upload the face sheet (the page with your name, limits and dates).
  • Practice locations, with the group's name, Type 2 NPI and tax ID, office hours, and whether you're accepting new patients.
  • A covering colleague, whether the office is reachable by public transportation, and whether patients have 24/7 phone access to you or a covering clinician.

Authorize and attest

  1. Under authorization, allow every plan you're applying to (or all plans).
  2. Review each section and fix anything out of date, especially a new address or tax ID.
  3. Attest. Plans see the attested version, not your edits since then.
  4. Set a reminder for 120 days. CAQH emails you too, but those are easy to miss.

Practice Manager: help from your credentialing team

A Practice Manager account lets a group or credentialing company keep practice location, malpractice and contact details up to date and export them to a clinician's profile. One Practice Manager account can serve several client practices. What it can't do:

  • See the clinician's profile, attest, or authorize plans.
  • Overwrite your address, tax ID or group NPI. Update those yourself.
  • Finish the import. You open ProView, accept each exported section (it shows as pending until you do), then re-attest.

After a tax ID or address change, update CAQH and re-attest before calling plans. Reps often ask to pull your updated CAQH data.

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