How Often Should You Re-Attest Your CAQH Profile?

The Critical Role of CAQH ProView in Modern Healthcare

For healthcare practice managers and providers, the Council for Affordable Quality Healthcare (CAQH) ProView portal is the "source of truth." It is the primary repository where insurance payers, hospitals, and health systems go to verify professional credentials. However, simply creating a profile is not enough.

A stagnant CAQH profile is a liability. Payers require that the information within the portal is current, accurate, and—most importantly—attested. Failing to maintain this lifecycle can lead to claim denials, suspended provider numbers, and a direct hit to your practice’s revenue cycle.

The Standard Re-Attestation Timeline: Every 90 Days

The short answer to "How often should you re-attest?" is every 90 days.

CAQH requires providers (or their designated practice managers) to log into the ProView portal and attest to the accuracy of their data once per quarter. While this may seem frequent, it serves as a fail-safe for insurance companies. By requiring a 90-day update, payers are assured that they are not reimbursing providers with expired malpractice insurance, lapsed state licenses, or outdated office locations.

What Happens if You Miss the 90-Day Window?

If the 90-day mark passes without an attestation, your profile becomes "Inactive" or "Expired" in the eyes of participating organizations. While your data remains in the system, insurance payers may:

• Flag your claims: Automated systems often cross-reference CAQH status before releasing payment.
• Remove you from directories: Many "Find a Doctor" tools are powered by CAQH data. An unattested profile can lead to your practice disappearing from online directories.
• Trigger an Audit: Consistently missing deadlines can lead to a more rigorous manual review by health plan credentialing committees.

Beyond the 90-Day Rule: When You Must Update Immediately

While the 90-day attestation is mandatory, certain events require an update to your CAQH profile the moment they occur. Waiting for your next quarterly window to report these changes can cause significant disruptions.

1. Insurance Policy Renewals

Malpractice insurance (Professional Liability) is the most common reason for a "suspended" status. You must upload your new Certificate of Insurance (COI) and update the expiration dates as soon as your policy renews.

2. State License and DEA Renewals

Never allow your state medical license or DEA registration to expire in the system. Even if you have the physical paper license, if CAQH shows an expired date, the payer considers you uncredentialed.

3. Changes in Practice Location

In the B2B healthcare space, "roster accuracy" is a major compliance focus. If you move suites, open a new satellite clinic, or close a location, this must be updated in CAQH immediately. Payers use this data to send physical checks and legal notices.

4. Board Certifications

Achieving a new board certification or renewing an existing one should be documented immediately to ensure you are being reimbursed at the correct specialist rate.

The CAQH Re-Attestation Checklist

When you log in for your quarterly attestation, do not simply click "Confirm" without a thorough review. Use this checklist to ensure your profile remains "High Quality" (a metric CAQH uses to grade profiles):

• Provider Profile: Check for name changes or updated contact email addresses.
• Education and Training: Ensure any newly completed fellowships or residencies are logged.
• Specialties: Verify that the primary specialty is correctly categorized.
• Practice Settings: Confirm the "Primary" location is accurate for billing purposes.
• Identification Numbers: Cross-check NPI, Medicaid, and Medicare numbers.
• Professional Liability: Ensure the current policy is uploaded and the old one is archived.
• Disclosure Questions: Review the legal and disciplinary questions. If a provider has had a board action, it must be disclosed here to match the National Practitioner Data Bank (NPDB).

Best Practices for Managing CAQH Profiles

Managing CAQH for a single provider is manageable. Managing it for a multi-specialty group of 50 providers is a significant administrative burden. Here is how top-performing practices handle the workload:

Automated Reminders

Set calendar alerts 15 days before the 90-day expiration. CAQH sends automated emails, but these often go to the provider’s personal email or get buried in spam. A centralized practice management calendar is more reliable.

Centralized Document Scans

Maintain a digital folder for every provider that includes high-resolution scans of:

• State Licenses
• DEA and CSR certificates
• Board certifications
• Current CV (formatted in MM/YYYY for all entries)
• Current Malpractice COI

Proactive Document Uploads

When you receive a new license or COI, upload it immediately. You don't have to wait for the expiration of the old one; CAQH allows you to store the future-dated document so it takes effect automatically.

The Hidden Danger: "Data Discrepancies"

One of the biggest hurdles in provider enrollment is a discrepancy between CAQH and the provider’s CV or NPI profile. During the re-attestation process, ensure that dates match exactly. If a CV says a provider started a residency in July, but CAQH says June, a payer’s credentialing software may flag it for manual review, delaying your enrollment by weeks.

Why Practice Managers Outsource CAQH Management

Many healthcare organizations are moving away from manual CAQH management. The risk of a "hidden" expiration causing a $20,000 claim denial is simply too high. Professional credentialing services provide:

1. Continuous Monitoring: Ensuring no document expires without an update.
2. Expert Attestation: Managing the 90-day cycle across hundreds of providers.
3. Sanity Checks: Reviewing the profile for logical errors that could trigger a payer rejection.

By treating CAQH as a living document rather than a one-time task, practices can ensure a smoother revenue cycle and maintain standing with all major commercial and government payers.

Key Takeaways

• Quarterly Requirement: You must re-attest your CAQH ProView profile at least every 90 days.
• Document Priority: Update malpractice insurance and state licenses immediately upon renewal, regardless of the 90-day cycle.
• Directory Impact: Failure to attest can lead to your practice being removed from insurance "Find a Provider" directories.
• Revenue Protection: Unattested profiles are a leading cause of credentialing-related claim denials.
• Precision Matters: Ensure all dates on the CAQH profile align perfectly with the provider's CV and state board records.
• Proactive Management: Use automated alerts and centralized digital document storage to streamline the attestation process.