6 CAQH Mistakes That Hold Up Credentialing
Common CAQH mistakes are a quiet reason credentialing files stall. A plan cannot finish your file if your profile is out of date or incomplete. Here are six CAQH mistakes to check before you apply. For the full enrollment process, see our insurance credentialing page.
6 CAQH mistakes to avoid
- Expired documents. Upload a current license and malpractice certificate.
- Outdated practice locations or phone numbers. Plans use them in directories.
- Forgetting to authorize the plan. If a plan is not authorized, it cannot see your profile.
- Missing your reattestation. Check your dashboard for the due date.
- Mismatched details. Your name, Tax ID and address should match your applications.
- Leaving sections blank. Complete every section before you attest.
How to catch CAQH mistakes early
Before you apply, open the CAQH Provider Data Portal and read each section as the plan would. Compare it with your application, and confirm the plan is on your authorized list. A few minutes here can prevent weeks of back and forth, so make it a habit.
Fix CAQH mistakes before you submit
- Update expired items first.
- Re-check names, Tax ID and addresses against your NPI record and contracts.
- Authorize each plan you are applying to.
- Save a confirmation after you attest.
What to do if a plan flags your profile
Ask the plan exactly what is missing, fix it in CAQH and tell the plan once you have updated it. Keep a log of dates in your credentialing and network status record. The credentialing terms glossary explains the vocabulary.
Credentialing and billing share the data
Errors in your profile can later show up as claim denials. See denied claims follow-up and insurance verification, and use our insurance companies contact by state list for plan contacts.
Build a CAQH mistakes checklist
The easiest way to prevent CAQH mistakes is to use the same short checklist each time. Print it or save it. Review it before every application and every reattestation, and share it with anyone who helps with your profile.
- Documents are current and uploaded.
- Practice locations and phone numbers are correct.
- Each plan I am applying to is authorized.
- Details match my application and contract.
- Every section is complete and attested.
Avoiding CAQH mistakes saves you follow-up work. Our private practice management resources and the commercial payer glossary entry can help you keep the bigger picture in view.
Most CAQH mistakes are easy to fix once you know where to look. The hard part is catching them before a plan does. Give yourself a short review window before each submission. If you work with a billing partner, ask them to review the profile too, since a second pair of eyes often spots CAQH mistakes you stopped seeing. Fix them early and your applications move more smoothly.
How MCM South helps
MCM South is a billing company that works only in mental and behavioral health. We serve psychotherapists and psychiatrists in solo and medium-size practices. We handle credentialing and billing together. See who we serve.
CAQH mistakes FAQ
What are the most common CAQH mistakes?
Expired documents, outdated locations, an unauthorized plan, a missed reattestation, mismatched details and blank sections.
How do CAQH mistakes affect credentialing?
A plan cannot finish your file when your profile is incomplete or out of date, so the application can stall.
How do I fix a CAQH mistake?
Update the section, confirm the plan is authorized, attest and tell the plan.
Does MCM South help?
Yes. MCM South handles credentialing for psychotherapists and psychiatrists. See our [[/mental-health-billing-faq/|billing FAQ]].
Where MCM South works
MCM South works only in mental and behavioral health. We serve psychotherapists and psychiatrists in solo and medium-size practices across ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Need a payer contact? Use our insurance companies contact by state directory.
