More Dental Plans Use ADA’s CAQH ProView Profile for Dentist Credentialing

Kathy Morrow

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If there’s one thing we can all agree on, it’s that paperwork is a drag. So the industry trend of minimizing paperwork by streamlining the credentialing process that providers go through to contract with dental carriers is a welcome shift. In fact, the number of dental carriers using the ADA’s credentialing service, CAQH ProView, is growing.

In my home state of Arizona, carriers using the service include Delta Dental of Arizona, Aetna, Blue Cross Blue Shield of Arizona, Cigna, Guardian, Humana, United Concordia Dental, and United Healthcare. And I’m sure that these companies utilize the service nationwide. So what is making CAQH ProView the gold standard of credentialing services?

CAQH ProView Benefits 

CAQH ProView eliminates the need for dentists to complete duplicate paperwork for organizations that require their professional and practice information for claims administration, credentialing, directory services, and more. It’s easy for dental offices to sign up and maintain their profile. This ensures that authorized healthcare organizations and dental carriers have instant access and the most up to date data about your practice. 

With CAQH ProView, dentists can:  

  • Self-report and electronically store professional information in one user-friendly online data source and easily update it as needed.
  • Directly upload credentialing documents to improve the accuracy and timeliness of applications.
  • Share information common to multiple practice locations among providers in that practice.
  • Maintain control of professional information with security features and authorize specified organizations to receive it.

Best of all, CAQH ProView is free for dentists and their practice managers to use. You do not have to be an ADA member to use the service to simplify the credentialing paperwork process for your office.

Getting Started with CAQH ProView

Any practicing dentist in the United States can participate in the free CAQH ProView service. Dentists who have never set up a CAQH profile can review the credentialing application checklist at ada.org/CredentialingChecklist. To complete their profile efficiently, dentists should gather all required documentation prior to filling out their information. 

Most dentists will be required to upload a copy of their state license, a copy of their professional insurance face sheet, their practice information, and their National Provider Identifier (NPI) number. Some dentists may also need to provide their hospital affiliation information and copies of their anesthesia licensure, Drug Enforcement Administration (DEA) license, Controlled Dangerous Substances (CDS) license, Advanced Cardiovascular Life Support (ACLS) certification, Medicare and Medicaid numbers, and Basic Life Support (BLS) certification. 

First-time users can complete their profile in about an hour if the necessary items from the dental credentialing application checklist are readily available. The menu prompts in CAQH ProView will guide you through each step. You control which organizations may receive your profile information, either by authorizing all of them or specific ones, such as Delta Dental of Arizona.

Already Registered with CAQH ProView? 

If you have used CAQH ProView before, it is recommended that you access and review your profile at ada.org/GoDigital. Take note of the important items below to ensure you successfully update your profile prior to your next re-credentialing:

  • Add new documents to replace any expired ones.
  • Leave no gaps in your work history for the most recent 5 years, or list the reasons for any gaps as appropriate, such as leaves of absence, maternity leaves, or illness.
  • Ensure that a current copy of your liability insurance is attached to your CAQH profile.
  • If you only authorize specific organizations access to your profile, be sure to add the dental carriers you work with, such as Delta Dental of Arizona. 

If you have questions or need assistance setting up your profile, there is a chat icon at the top of each page in the system. You can also call the CAQH Help Desk at (888) 599-1771, Monday through Thursday from 7 am to 9 pm (ET) and Friday from 7 am to 7 pm (ET). 

For more information about CAQH ProView, visit ada.org/credentialing

Ms. Morrow is the director of professional relations at Delta Dental of Arizona. She has more than 30 years of combined experience working in the dental insurance industry and managing dental office operations. She can be reached at kmorrow@deltadentalaz.com.

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