One-Stop Credentialing Application - CAQH

Medical Mutual 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 Medical Mutual’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 Medical Mutual 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

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