CAQH ProView. Practice Manager and Provider Frequently Asked Questions

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1 CAQH ProView Practice Manager and Provider Frequently Asked s *s related to the CAQH ProView Practice Manager Module begin on page 2. *s on the CAQH ProView system for providers begin on page 6. 1 P age

2 CAQH ProView Practice Manager Module Getting Started s 1. What is the purpose of the CAQH ProView Practice Manager Module? CAQH ProView s Practice Manager Module allows practice managers to enter data one time for multiple providers. The data can then be exported to the individual provider data profiles. Access the Practice Manager Module quick reference guide, user guide and video here: upd.php. 2. Was the data in my Practice Manager account migrated from the UPD system to CAQH ProView? 3. Will I have to create a new login if I already had a login with the UPD Practice Administrator Module? Yes, the data from UPD Practice Manager accounts migrated to the CAQH ProView Practice Manager Module. Some users have found a few fields that did not get migrated to the CAQH ProView Practice Manager Module. Data that was not migrated will need to be re- entered by the Practice Manager. You can use your UPD Practice Administrator Module username and password to initially access CAQH ProView s Practice Manager Module. You can keep your existing UPD username and password in CAQH ProView as long as it meets the new system requirements for username (8 characters with no special characters) and password (8 characters). You may be prompted to update your username and/or password if it does not meet the new system requirements. 4. Can the Security s be changed? At this time the security questions can not be changed. However, CAQH is reviewing this current set- up, so that users can change the security questions in the future. 2 P age

3 CAQH ProView Practice Manager Module Managing Users 5. What is the difference between Basic User and Admin User? Can there be more than one Admin? The only difference between Admin Users and Basic Users are that Admin Users have the ability to edit users via the Manage Users screen of the Practice Manager account. There can be more than one Admin User and more than one Basic User within a single Practice Manager account. 6. How do you delete users from a Practice Manager account? 7. I tried to add a user to my Practice Manager account, and the system says the user is already in the system. How can I proceed? At this time, users within the Practice Manager Module can not be deleted. However, an Admin User can mark the user s status as Suspended via the Edit User screen within the Manage User section. At this time, CAQH ProView only allows a specific address to be tied to one practice manager account. However, a change is in progress to allow the same address to be tied to multiple practice manager accounts. CAQH ProView Practice Manager Module Setting Up Large Practice Groups Across Multiple States 8. How should a group with multiple TINS and practices set- up their practice manager account? You can use one account for multiple groups with multiple TINS if you prefer. Within your account you can set up different groups with different states. You can do this in the Manage Practice section. Add a different "Practice" for each group. In order to drive any required state specific application questions, you must create a different Practice for each different state. 9. In UPD s Practice Administration Module, we had multiple practice manager logins for different states. Now that we can put all of these in one practice manager account, can we have these accounts merged? Unfortunately, CAQH cannot merge practice manager accounts. 3 P age

4 10. What is Bulk Upload? Bulk Upload is a new functionality offered through the CAQH ProView Practice Manager Module. Its purpose is to assist large practices with the data entry process for multiple providers. Practices can upload a data file, in the required file format specifications, to be processed by CAQH and automatically exported to the individual provider data profiles. The information will then be available for import within each individual provider profile. More information on the Bulk Upload function is available on the Resources page within the Practice Manager Module. Note: CAQH is reviewing the bulk upload functionality to ensure this new feature meets expectations. Requests to use bulk upload will be processed once the function is available. CAQH ProView Practice Manager Module Exporting Data 11. How does the export/import process work? Where does the data go when exported? 12. If the Practice Manager made a data entry mistake after exporting data is the Practice Manager able to recall or rescind information already exported? 13. If a Practice Manager exports information to a provider and the provider imports it, will future updates made to that information within the Practice Manager Module automatically update the provider s data profile? A Practice Manager can export information for multiple providers to the individual provider data profiles. The exported information is then available to the providers to be imported within their data profile. There is an Import button that becomes activated within the section of the available data for import. A provider can either choose to accept or reject the data that is available for import. Once the data is imported, the data can be edited before the provider saves and attests to the information. No, once data is exported to a provider data profile, a Practice Manager can not recall the data. However, a provider is able to review data before choosing to either reject or accept the available data for import. No, any new updates entered within the Practice Manager Module would need to be exported again to the provider. The provider would then need to import the updated data and complete attestation so that the data updates are available to the health plans. 4 P age

5 CAQH ProView Practice Manager Module Adding New Providers 14. Can a practice manager add providers to CAQH ProView, or does the health plan still have to register them first? 15. When I have a new provider, can I use the information I have previously entered in the Practice Manager Module to assist with completing the new provider s data profile? 16. I need to add a provider to my Practice List within the Practice Manager Module and I can not find the provider via the provider search. Providers can self- register with CAQH ProView by clicking on Register on the CAQH ProView login page: https://proview.caqh.org. By self- registering with the system, a provider will obtain a CAQH Provider ID number. Yes, you can add the new provider to your Provider List and then export any of your saved data within the Practice Manager Module to the new provider s data profile. Data sections that can be exported to multiple providers include the Credentialing Contact, Professional Liability Insurance, Practice Location, and Hospital Affiliation sections. It is possible the provider has not yet registered with CAQH ProView. The provider can self- register with CAQH ProView by clicking on Register on the CAQH ProView login page: https://proview.caqh.org. CAQH ProView Practice Manager Module General s 17. Will practice managers be able to upload a provider s supporting documents using the Practice Manager Module? No. All supporting documents will need to be uploaded within the individual provider s data profile. 18. Why are there no red asterisks within the Practice Manager Module to indicate which fields are required for providers? 19. Can the practice manager attest on behalf of the provider within the Practice Manager Module? In the CAQH ProView Practice Manager Module, required fields that must be completed by providers are not indicated at this time. However, in the provider system, the required fields are indicated with red asterisks. We will research this request to see if the required fields that providers must supply before attesting can also be shown on the Practice Manager Module. No, the practice manager can enter data into the Practice Manager Module and export that data to a provider s data profile, but cannot complete the attestation for the provider in this module. Attestations must be completed within the individual provider accounts. 5 P age

6 CAQH ProView for Providers: General s 1. Was the data for providers migrated from the UPD system to CAQH ProView? 2. Why is my residency information now located in the internship section? Yes, the data from Universal Provider Datasource was migrated to CAQH ProView for providers who had completed applications in the UPD system and had attested to the completed applications at some point prior to the system transition. During the data migration of Internship and Residency data to CAQH Proview, the system was not able to distinguish which data was an internship and which data was a residency. As a result, all internship and residency data were migrated to the Internship section in CAQH ProView. When you look at the Internship section, you will see that the first field in the data block is called Type. To move an Internship record into the Residency section, please select Residency as the Type dropdown, and then click Save & Continue. The data that was in Internship should now appear in the Residency section. 3. Will I have to create a new login if I already had a login with the UPD? You can use your UPD username and password to initially access CAQH ProView. You can keep you existing UPD username and password in CAQH ProView as long as it meets the new system requirements for username (8 characters with no special characters) and password (8 characters). You may be prompted to update your username and/or password if it does not meet the new system requirements. 4. Can the Security s be changed? At this time the security questions can not be changed. CAQH is reviewing this current set- up however, so that users can change the security questions in the future. 5. Can a provider self- register with the system? Providers can self- register with CAQH ProView by clicking on Register on the CAQH ProView login page: https://proview.caqh.org. By self- registering with the system, a provider will obtain a CAQH Provider ID number. 6. How can I obtain a CAQH Provider ID number? CAQH ProView generates CAQH Provider ID numbers either when a new provider is submitted on an organization s roster or 6 P age

7 7. Will providers continue to get re- attestation reminders via ? when a provider self- registers with the system Yes, re- attestation reminders will be sent to providers before attestation is due and once attestation is expired. CAQH ProView for Providers: s on Navigating the System 8. Where do I access the Authorization screen to edit the organizations that can view my data? The Authorization page is located in Account Settings. Click on the gear in the upper right corner of the home page. Select the Authorization item from the menu. 9. Why does CAQH ProView ask if I will authorize release of a more limited set of my data to organizations with which I am NOT affiliated? Organizations need data for providers who are not affiliated or participating in their network in order to pay out- of- network claims. For example, if a health plan would like to verify a non- participating provider s address before they submit payment for the claim. Within CAQH ProView, providers have the option to either grant global authorization to all health plans who indicate the provider is not affiliated or to select the individual plans who have indicated the provider is not affiliated. By selecting the latter option, the provider will be able to view which health plans have asked to view a limited set of their data and can grant access via line item authorization. 10. How can I remove a data entry from the Education section or any other section? How does the Remove button work? 11. Is there a way to delete a primary practice location once it has been entered and saved? 12. What do the red asterisks mean next to some fields? Why do some required fields not present until I get to the Review section? To remove a data block, select the "Remove" button. This will highlight the data block in pink. Then select Save and Continue to proceed, when you return to that page the data entry you selected for removal will no longer be present. Yes, navigate to the Practice Locations tab in the provider view. Identify the primary practice location record. Select the delete button for the record you wish to delete. The entire practice location record will be deleted. The red asterisk represents required fields. If there is no red asterisk, the field is not required. CAQH ProView will allow you to go from page to page without entering all of the data until you reach the Review page. At the time, any outstanding required fields need to be completed 7 P age

8 before attestation can be completed. 13. In date fields, the calendar only shows How do you get to previous dates or extended dates? On the calendar widget, click on the year. When you click on the Month and Year, the display will change to Year only. The arrows on either side of the year will allow you to select a year in the past or a year in the future. 14. What does the Import button do? Practice managers can enter data that is common for multiple providers into the Practice Manager Module and then share that data with their providers to ease the data entry process. The Import button will be blue if there is no information to import. It will be red if there is information to import. By clicking on the Import button, you will see the data available to you and can either choose to accept or reject the data. CAQH ProView for Providers: s on Specific Data Profile s 15. Why does the system present a suggested fix for DEA, NPI and/or license number when the number entered is in fact correct? CAQH is currently researching these suggested fixes to ensure the data validation is working correctly. Please check that the information is correct to the best of your knowledge and continue to the next step in completing your data profile. Suggested fixes will not prevent you from completing your data profile. 16. Why does CAQH still collect UPIN? UPIN is included in CAQH ProView at the request of some health plans that use UPIN to link data within their internal systems. 17. Why do we need to provide so much information, e.g. social security number, home phone number and address, professional references? 18. What is the purpose of the Disclosure of Ownership section? These fields have been part of the credentialing process for some time and are carry- overs from the previous UPD system. At this time, they are part of the CAQH ProView system because they were asked for historically. We will be conducting an assessment of the usefulness of these fields in the coming months. CAQH ProView includes a new group of questions within the Disclosure section. These questions are related to disclosing any ownership or financial interests related to the location a provider practices. These questions are optional; however, many health plans do require this information during the 8 P age

9 credentialing process. For these questions to be accessible to authorized health plans, providers need to print, sign, and then upload the DOO form via the Documents tab. 19. Is there an end date for a practice location? 20. If we have an interpreter service line that offers all languages, should we check off all languages, or just leave it blank? 21. Can the primary for a provider s account be the office credentialing contact? Practice location information should be filled out for locations in which you are currently practicing. If you have a practice location in your profile that you are no longer practicing in, please add an entry to the Employment Information section. You should select all of the languages. Primary Method of Contact can be a credentialing contact. The primary is also associated with the username and password for the account. CAQH ProView for Providers: Submitting Supporting Documents 22. Were supporting documents migrated from the UPD system into CAQH ProView? 23. What does the status Ready to Review mean? 24. How long does it take for CAQH to review uploaded documents? 25. Can you remove a document once you have uploaded it? 26. How often does a provider need to physically sign the attestation release form? Yes, supporting documents for providers who had complete, attested records in UPD were migrated to CAQH ProView. This means CAQH is reviewing the submitted document for accuracy. This process takes approximately 48 hours upon submission. CAQH will review all supporting documents for accuracy upon submission to confirm the document type, to ensure the effective date is valid, and to verify a wet signature is present on the initial attestation form for new providers. This review is completed within approximately 2 days. If you upload a document and wish to delete it, you can do that on the Documents screen. A provider only needs to submit a signed attestation release form during the first attestation process. The provider can complete all further re- attestations on the system. No additional signed copies are necessary. 9 P age

10 27. I tried to fax my insurance certificate and that fax number doesn't work anymore. Is there a new fax number? CAQH ProView no longer supports faxing of supporting documents. Documents can now be uploaded directly into the system via the Documents tab. This is a more efficient and secure method of document submission. 10 P age

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