Most therapists file their first credentialing applications and then wonder why nothing moves. CAQH is usually why.
Almost every major commercial payer — Aetna, Cigna, BCBS, United — pulls from CAQH to verify your credentials before approving your application. If your profile is incomplete, expired, or has the wrong taxonomy code, your application stalls. You won't get a rejection letter that says "CAQH issue." You'll just wait. Then call. Then wait more.
This is fixable. But you have to do it before you start applying, not after.
What CAQH Actually Is
CAQH ProView is a centralized credentialing database used by over 1,000 health plans and hospitals. Instead of submitting your credentials to every payer separately, you upload them once to CAQH and authorize each payer to access your file.
When a payer receives your credentialing application, one of the first things their credentialing team does is pull your CAQH profile. If it's incomplete, they stop and send it back. If it's expired, they stop. If your taxonomy code doesn't match what you put on the application, they stop.
Your CAQH profile isn't a nice-to-have. It's the source of record.
What Goes In Your CAQH Profile
There are six areas that directly affect credentialing outcomes:
Personal and contact information. Your legal name must match your license exactly. Use your full middle name if it's on your license. A single-character mismatch between CAQH and your state license board entry will create a verification flag.
Licenses and certifications. Enter your state license number, issue date, expiration date, and jurisdiction. If you hold licenses in multiple states, enter all of them.
NPI number. Your Type 1 (individual) NPI. Double-check it against NPPES. If it's wrong in CAQH and wrong on your application, no one will catch it until after a denial.
Taxonomy code. This is the one people get wrong most often. For licensed clinical social workers: 1041C0700X. Licensed professional counselors: 101YM0800X. Marriage and family therapists: 106H00000X. Psychologists: 103T00000X. Do not guess.
Malpractice insurance. Policy number, carrier name, effective dates, and coverage amounts. Most payers require at least $1M per occurrence / $3M aggregate. Upload the actual certificate of insurance.
Work history. Five years of employment history is standard. Gaps need an explanation. Unexplained gaps are a credentialing red flag.
Setting Up Your Profile: Step by Step
Go to proview.caqh.org and create an account. Fill out every section completely. Upload supporting documents for each section. Complete the authorization step — this is where you specify which payers can access your profile. Then submit your attestation. Completing your profile without attesting means it's not live.
The 120-Day Rule
CAQH requires re-attestation every 120 days. If you don't log in and confirm your information is current, your profile goes inactive. An inactive profile is treated the same as no profile — payers can't pull it.
This catches therapists mid-credentialing more often than you'd expect. You submit an application in month one. Your CAQH expires in month three. The payer tries to pull your file in month four and gets nothing.
Set a calendar reminder for every 90 days. Log in, review, update if needed, re-attest. It takes five minutes. Missing it costs weeks.
Before You Apply Anywhere
Credential your CAQH profile before you submit a single insurance application. Confirm your taxonomy code is correct. Upload every document. Complete your attestation. Then apply.
The credentialing process is slow enough when everything goes right. Don't give payers a reason to stop your application before they've even started reviewing it.
If this kind of practical credentialing content is useful to you, the therapypractice.ai email list is where more of it lives — built for solo practice owners who bill insurance and want the business side to stop being a guessing game. Join at therapypractice.ai.