If you plan to bill any commercial insurance payer, you're going to need a CAQH (Council for Affordable Quality Healthcare) ProView profile. CAQH is a universal credentialing database used by nearly every health insurance company in the United States to verify provider information. Think of it as the central hub where payers go to check your credentials, and without a complete, current profile, your credentialing applications will stall or be denied outright.
This guide walks you through the entire setup process so you can get it done right the first time.
What Is CAQH ProView and Why Does It Matter?
CAQH ProView is a free, online credentialing application that collects and stores your professional, practice, and insurance information in one standardized format. Instead of filling out separate applications for every payer you want to join, you complete one CAQH profile and authorize payers to access it.
Before You Start: Gather Your Documents
The number one reason OTPs get stuck during CAQH setup is not having their documents ready. Collect everything before you sit down to fill out the application.
Required Documents and Information
You will need your NPI number (both Type 1 individual and Type 2 organizational, if applicable), your state OT license number and expiration date, your Social Security Number or Tax ID / EIN, your DEA number (if applicable — most OTPs won't have one), professional liability (malpractice) insurance certificate with policy number, coverage dates, and limits, your current CV or resume with complete work history (no gaps), diploma and transcripts from your OT program, board certification documentation (NBCOT), any specialty certifications (CHT, CLIPP, CAPS, etc.), a list of hospital privileges (if applicable), your practice address, billing address, and contact information, and a W-9.
Step-by-Step Profile Setup
1. Register for a CAQH ProView Account
Go to proview.caqh.org and click "Register." You'll need your NPI number to get started. If a payer has already initiated your profile (some do this automatically when you begin credentialing with them), you may receive a CAQH ID in an email. If not, you can self-register.
After registration, you'll receive a CAQH Provider ID number. Save this — you'll need it for every credentialing application going forward.
2. Complete the Personal Information Section
This section covers your legal name, date of birth, Social Security Number, contact information, and demographic details. Double-check that your name matches exactly what's on your NPI registration and state license. Even minor discrepancies (middle initial vs. full middle name) can cause credentialing delays.
3. Complete the Professional Information Section
This is where you'll enter your education history, including your OT degree program, graduation date, and any additional degrees. You'll also enter all of your professional licenses with their numbers, states, issue dates, and expiration dates.
4. Complete the Practice Information Section
Enter your practice location(s), including the physical address where you see patients, your billing address (if different), phone and fax numbers, office hours, and your practice's Tax ID or EIN. If you're a solo practitioner operating under your own name, your SSN may serve as your tax ID until you've set up your business entity.
5. Complete the Work History Section
CAQH requires a complete, gap-free work history going back at least five years (some payers look back further). For each position, include the employer name, dates of employment, position title, and reason for leaving. Any gaps longer than 30 days must be explained — acceptable explanations include family leave, education, relocation, or job searching.
6. Upload Required Documents
Upload digital copies (PDF preferred) of your malpractice insurance certificate, state license, NBCOT certification, and any specialty certifications. Make sure documents are current and legible.
7. Complete the Disclosure Section
This section asks about malpractice history, license actions, criminal history, and other disclosure questions. Answer honestly — credentialing committees verify these answers against national databases, and discrepancies can result in denial.
8. Authorize Payers
This is a critical step that many providers miss. After completing your profile, you must specifically authorize each insurance company to access your information. Navigate to the "Manage Authorizations" section and select the payers you plan to credential with. If you're not sure which payers to authorize, start by authorizing all available payers in your state — there's no cost or downside to broad authorization.
9. Attest and Submit
Review your entire profile for accuracy, electronically sign the attestation, and submit. CAQH will email you confirmation.
After Submission: What to Expect
Re-attestation Requirements
CAQH requires you to re-attest (confirm that your information is still accurate) every 120 days. Mark this on your calendar. If you miss re-attestation, your profile becomes inactive and payers can't access it — which can delay claims and credentialing.
Keeping Your Profile Current
Log in and update your profile anytime something changes: new license, new practice address, updated malpractice policy, or additional certifications. Keeping your profile current prevents credentialing delays down the road.
Timeline Expectations
Setting up your CAQH profile takes one to three hours if you have all documents ready. After submission, it typically takes payers 60 to 120 days to complete credentialing using your CAQH data, though some process faster. Don't wait until you have patients to start this process — begin CAQH setup as soon as you have your NPI and business entity established.
Common CAQH Pitfalls
Name mismatches across documents. Your name on CAQH must match your NPI, license, and malpractice certificate exactly. Resolve discrepancies before submitting.
Gaps in work history. Unexplained gaps trigger credentialing committee review. Account for every month.
Expired documents. Uploading an expired malpractice certificate or license will halt your application. Check expiration dates before uploading.
Forgetting to authorize payers. Your profile can be complete and perfect, but if you haven't authorized the specific payer to access it, they can't see it. Authorize broadly.
Missing re-attestation deadlines. Set a recurring calendar reminder for every 90 days (giving yourself a 30-day buffer before the 120-day deadline).
Credentialing is one of the most tedious but essential steps in building your OT practice. OT Connected walks you through the business side of OT so you can focus on what you do best — helping people.