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Behavioral Health Services
Behavioral Health Services

Create a CAQH profile

If you are a licensed or certified provider, we require you to have a valid Council for Affordable Quality Healthcare (CAQH) provider profile as part of the credentialing process.

To create a CAQH profile, register for an account at the CAQH Provider Data Portal and initiate the application process.

  • Your CAQH application will generate a CAQH Provider Profile ID#.  Share this number with us as part of your credentialing application.
  • The CAQH application can be completed by either administrators or providers. Note, however, you will still be required to attest and re-attest in the system with a date and signature to the information on the application. 
  • For questions about specific work location, contact your office manager.

Tips and checklists

Here are some pointers and resources for the CAQH application process.

  • We must verify the attestation date on the CAQH report (page 1). 
  • We cannot accept a CAQH attestation that is more than 120 days from the date of our review. 
  • Ensure that your CAQH is always up to date. CAQH will send you reminders. 
  • CAQH information and attestations that are out-of-date and incomplete can significantly delay the credentialing and provider load process.
  • Consult this guide on CAQH application steps.
  • Need help navigating the Provider Data Portal? Visit Getting started or call (888) 599-1771.
CAQH Checklist
  • Name
  • Date of birth 
  • Social security number 
  • License/Certification/Registration/Associate number
  • DEA (if applicable) 
  • Are you participating in Medicare/Medicaid (if applicable, Y or N question)
  • Medicaid and Medicare numbers (if applicable)
  • NPI 
  • Education
  • Specialty (i.e. provider type) 
  • Board certification (if applicable)
  • Primary practice address, includes tax ID of group, phone and fax numbers
  • Remittance and pay-to information, including the name that checks are made payable to and payment address
  • Office hours
  • Services and accessibilities section (if applicable)
  • Hospital affiliation (if applicable)
  • Professional liability insurance (please ensure it is not expired) 
  • Work history (must be for last 5 years with no more than a 6 month gap. If there is a gap, there must be an explanation. We can also use education to help fill in the last 5 years) 
  • Disclosure questions (must be completely filled out) 
  • Any additional addendum pages (if applicable) 
  • Any additional locations (please ensure this is completed for any additional locations)