A CAQH profile is an online credentialing record maintained through the Council for Affordable Quality Healthcare (CAQH) ProView system. It serves as a centralized repository of professional and practice information that healthcare providers—including pharmacists—can share with health plans, pharmacy benefit managers (PBMs), and other organizations for credentialing and network participation.
Why a Pharmacist Should Have a CAQH Profile
As you start offering more clinical services a CAQH profile may be helpful to you. A CAQH profile helps by:
- Streamlining credentialing: Submit information once and share it with multiple organizations
- Supporting provider status expansion: Useful for pharmacists entering collaborative practice or provider roles
- Maintaining professional records: Keeps licenses, certifications, and work history organized and up to date
How to Get a CAQH Profile
You can register for and manage your profile through the CAQH ProView website. Registration is free for providers.
- Obtain an NPI (if you don’t already have one)
- Register on CAQH ProView using your personal and professional details
- Complete all profile sections, including education, licensure, and work history
- Upload supporting documents (e.g., license, malpractice insurance)
- Authorize access for organizations that request your information
- Attest to the accuracy of your profile before submission
Information to Have Ready
Before starting your CAQH profile, gather the following:
- Personal information (SSN, date of birth, contact details)
- NPI number
- State pharmacist licenses (active and past)
- Education and training history
- Work and practice history (including explanations for gaps)
- Board certifications or credentials
- Malpractice insurance details (if applicable)
- Practice locations and affiliations
- References (if required)
Having this information prepared will significantly speed up the process.
Re-attestation Requirements
CAQH requires providers to re-attest to their profile every 120 days. This is a critical step to keep your information active and usable by payers.
- You will receive email reminders when re-attestation is due
- Review and update any changes (licenses, employment, etc.)
- Re-attest even if nothing has changed to confirm accuracy
- Failure to re-attest may result in delays in credentialing or reimbursement
Key Takeaway
A CAQH profile is an essential tool for pharmacists seeking to expand clinical services and participate in payer networks. Keeping your profile complete, accurate, and regularly re-attested ensures smoother credentialing and uninterrupted reimbursement.