One-Stop Credentialing Application - CAQH
Carolina Care Plan has joined other health insurers who participate in the HIPAA compliant, one-stop credentialing application process developed by the Council for Affordable Quality Healthcare (CAQH) using Universal Credentialing DataSource. As a result, all new professional providers making application to any of Carolina Care Plan’s networks are now required to use CAQH as their vehicle of application. CAQH is a not-for-profit organization created in 1999 and made up of health insurers and networks that promote initiatives aimed at reducing costs and streamlining administrative procedures related to health care. The Universal Credentialing DataSource was created to simplify the credentialing and recredentialing application processes. CAQH provides these services at no cost to providers.
CAQH enables health care providers to enter required credentialing information one time, either online or by fax, to satisfy the credentialing and recredentialing requirements of ALL participating plans. Updating credentialing information takes only a few mouse clicks, with all changes made immediately available to health insurers and other entities authorized by the provider. All data is secured through the use of state-of-the-art encryption technology. CAQH also enables one-time entry of data common to multiple providers, facilitates quick and easy location of contact information for colleges, medical schools, and hospitals, and automatically checks for errors in the application. Please see http://www.caqh.org/ for more about CAQH.
All Carolina Care Plan network providers are eligible to participate in CAQH and are encouraged to do so. Any questions related to participating in CAQH or the status of their credentialing or recredentialing application should be directed to your Professional Contracting Representative
Practitioners are reminded that they are afforded the right to review the information obtained in support of the recredentialing application, as well as correct any erroneous information. Practitioners requesting to be informed of the status of their credentialing or recredentialing application may contact a Carolina Care Plan contracting representative at the following location:
Professional Contracting
Network Management
201 Executive Center Drive
Columbia, SC 29210-8438
Phone: 803/750-7400 or
Toll Free: 800/868-6734