Council for Affordable Quality Healthcare [CAQH]
Reviews and Complaints

After logging in to review and attest, a system notification appeared informing that my insurance had expired (it had in fact been renewed and uploaded). I needed to delete per instructions that i was reading, 4 expired insurance documents. there were more than 4 on that page and I didn't know which ones to delete. So I called for assistance.

I never did get my questions answered but was told I didn't need to delete anything. and i over validated my identity in order that the rep could attest for me. it was the only thing she was prepared to do.

The questions about telehealth (which i had also seen were fixes) remained unasked/unanswered. The expired documents are not deleted.

There is a real disconnect here. I am confused about this system, it seems to run poorly. Why am i being asked to do things and then told they aren't necessary and without explanation?

Every time the site tells me I am deficient in liability insurance. Yet, the document is right there on their site. So, I tried to go in and put information in all of the required fields. When I hit "save, " it deletes my information.
There are problems every single time. This should be a 5 minute process and it turns into 30-40 minutes. Clean it! Fix it!

IN the last year I have had very difficult experiences with your customer service folks as follows:

They provide little information as to how they are working to help you
Much of there time is spent telling me they will help me with my issue
It is very difficult to understand them due to their poor english and accent
Recently the noise of wind, chickens clucking and children crying could be heard in the background.
They do not respond to clarifying questions, instead talk of something else
Recently they ask multiple questions for verification that go far beyond what is necessary.
A recent contact was with someone very rude.

I have been trying to set up EFT for two months with this group. They call over and over again asking for the same information. I have spoken to at least five different people thus far. No matter how many times I try to straighten out their problem, I am again sent a message that my enrollment has been declined. Now, I was just disconnected (perhaps because I told the representative that I could not understand him and asked him to repeat himself?)

When I set up direct deposit with Optum, it took LESS THAN A WEEK WITH practically no effort. I don't know why major insurers are forcing providers to use this method, but it is a disaster.

What a complete waste of time and energy! It doesn't matter how much information you enter because they always show errors. When those errors are corrected, and saved, they still will not allow you to attest. I have literally entered the same information five times, saving each time, and it will still come up as an error. The most useless and aggravating pile of [censored] I have ever encountered. It's been like this for as long as I can remember. I refuse to fill out any further info. These people make the DMV a pleasure to visit.

In April I completed the online registration for our medical practice in CAQH HubEnroll.

I was never contacted for verification or notified the enrollment was denied for lack of verification.

I contacted CAQH HubEnroll had to give all the information again, was put on hold total time on telephone was over 30 minutes. An appointment was set up I was told for 2 days later. No one called to complete the verification on that day or the next day. I called again went through the same process of another 30 minutes on the phone and was told someone would call me
in 15 minutes . Of course no one called! I signed into our account and saw that they tried to call at 5:07AM EST which is absolutely ridiculous and they declined the enrollment again stating they could not contact anyone.

I called again this morning and was told they would schedule another call. I became extremely angry and asked for a supervisor was put on hold and of course informed there was not one available. I absolutely insisted on speaking to someone immediately for the verification and put on hold again. During the time I was on hold another call came in and it was someone asking to verify our enrollment. Finally the process was complete.

The problem as I can determine is that first of all this process is outsourced outside of our country. The representatives are extremely difficult to understand due to their accents and they absolutely do not call within business hours as stated due to their location.
Who is responsible for this outsourced groups supervision to ensure they are performing their job? Quite obviously no one as I can see the same complaints repeatedly by other medical practices.

On May 22, 2020 I logged into CAQH Enroll Hub to change financial institutions for EFT's. I was able to change two of the financial institutions listed under our practice but the system will not let me change the financial institution in the system for Aetna and Cigna. I have been working on this issue for two weeks not without any success.

I have asked for a supervisor and was told a supervisor was not available. I have gotten nowhere with this company. They keep telling me they have escalated the issue to the technical team. That was a week ago that it was supposedly escalated to their technical team and still nothing!

There has to be someone other than CAQH Enroll Hub to go through to change an EFT and ERA's. This company is incompetent.

I have been with caqh for 2 years now. Suddenly my password doesn't work, and the reset password questions do not get me through to change my password without error when I know the answer. So I call for help. They want me to give them the names of all of my era's and eft's, but I have no eft's set up nor do I get any checks that way. So they won't let me talk to a manager or reset my password because I can't give them the name of the eft! It obviously is fraud and I cannot get passed it. They won't let me in because I don't know the answer to the fraudulant information. Help!

Hello,

I have 5 physicians I have been trying to enroll. The status is denied due to verification. We were not able to reach anyone with the providers office. This is so false. I am a billing service. It is me, and me alone. I have not received a call on the providers they have denied.
Last Thursday I did finally get a call on one of my doctors, I verified everything. Now it is the same message on his status. We were unable to reach anyone regarding...…..They talked to me!
I call and I call and I am literally on hold for an hour each time, I don't have that kind of time.
I am trying to bypass all this and do the carriers direct.
Very disoriented. Very unorganized. This has been going on for over a month!

I have been trying to enroll in EFT via CAQH EnrollHub for about 4 weeks. My bank letters and now my voided check have all been rejected or denied. This morning I called the company and was on with a representative for 27 minutes before he informed me that what I had requested could not be done. During this time he had me log in and out several times and repeatedly asked for information that I had provided several times during the call. When I asked for a supervisor, I was told I supervisor would not take my call. When I inquired further about a supervisor refusing to speak to me I was hung up on. I know I was hung up on because at the beginning of the call he asked for my call back number and it was provided in the event that we were disconnected, but I was never called back. So I called back and reached Bella, who it only took 10 minutes to tell me that her supervisor, Rose was not going to take my call.

Now in addition, to having such an unprofessional and rude phone conversation with this organization this morning there have been several emails and phone conversations in the past that could have solved this problem hopefully sooner. My check and bank letters only had my name (Monica Sparks). The information/instructions on the CAQH provider profile page states "Please enter information about the practice or company that you wish to enroll. The provider name or the DBA that you enter here must match the name that appears on the voided check or bank letter that you will be asked to upload later in the process."

The or to me indicated that at least one of the names needed to match. After 4 weeks and no success I attempted to remove the DBA and just use my name as the provider. When I was unable to edit that information I called.

So as of now I still have no resolution and it appears I am not the only one having issues with this organization. I hope something can and will be done as receiving compensation for services is a very important part of doing business.

What a waste of time and resources. This dept is outsourced to the phillipines and can never reach a supervisor as they are always in meetings. Despite being told I would get a call back noone has ever called me back. 6 weeks now and counting to get admin privileges taken off old admin and reassigned to our provider directly. Incompetent business line and no accountability whatsoever. This is banking information they are playing around with... Filing a complaint with the business licensing of washington dc for caqh the company

I've been contracted by a provider who back in July 2018 purchased an already running clinic and changed the NPI and TIN because it was a non profit clinic before. She has been trying unsuccessfully for two months now to get the NPI &TIN changed. This has cripled her practice as she has zero accts receivable coming in because all efts are tied up in the ongoing excuses that "were behind and there was a system glitch" excuse. I called myself in Monday morning and was told I works receive an email shortly with the user name I requested and I works then be able to update the system with the new practice info. Two calls later to a lady with a thick accent and no email yet!

I would like to file a complaint related to your format and processes which essentially cause delays in credentialing and ultimately prevent gainful employment. There are many elements to this, but two which stand out are the lack of competent staffing and the format of the forms which are biased toward certain types of providers.
The chat line assistance staff does not appear to have the expertise necessary to understand the myriad of providers, and are not able to provide the level of expertise needed to fill out the forms. It is basically like talking to a robot or listening to a broken record because there are no critical thinking skills or application.
The second issue is the computer format is not tailored to providers who may be locum providers or do not own clinics and labs. However, as one fills out the questions, the forms demand answers and information, which when answered directly and truthfully, does not apply because it is not intended for the type of provider filling out the mandatory questions. Its like trying to fit the many shapes and sizes of providers (circles, stars, triangles) into a square.in order to answer questions
That must be attested to, one gets sent down a path to answering questions which do not apply. It's a big mess! One problem I had was the demand for a run sheet and insurance data which does not apply to federal employees. Even though I explained this, I keep getting kick backs and rejections. No one seems to understand federal tort, and yet you are in the business of credentialing? So far my estimated pay losses exceed 8000.00 and loss of health insurance due to the delay as a result of caqh lack of knowledge related to various provider circumstances and what you can and can not demand of people in order to credential them so they can work. If you are entrusted to be a gatekeeper to whether people can put food on the table and pay their bills, should you not know what you are doing at a level that would not result in this kind of delay? You should be ashamed!
Credentialing bodies need to be regulated and have rules such as reasonable time limits to credential! Fines and penalties should ensue if you demand things that do not apply to the provider and this result in delays in employment. Caqh should pay a fine for each day over a certain time limit, example two weeks. I think most doctors would agree to about 1, 000 per day for unfounded delays and harassment.
Zero stars

Week of September 9, 2018
CAQH has a rigid template format and processes which do not always apply to everyone depending on their situation.
The credentialing process of CAQH demands that one has personal liability insurance. It completely ignores federal employees covered by Federal Tort and makes demands that you have a statement of no insurance or they hold up your gainful employment. I received three "failed" notices for the personal insurance criteria, despite uploading a statement which reminded them that federal employees are covered by federal tort. They do not seem to comprehend this, and get very nit-picky, requiring one to provide policy data that does not apply in their email messages. A representative on the chat function stated to print, sign, upload, scan a piece of paper indicating that I do not have insurance. Why is this necessary? Should not the template already have a way to address and attest to this? Why hold up the employment of an individual over something so trivial? Do they not know this about federal employees, yet they are in the business of credentialing? Instead, I have to purchase a scanner and go through multiple steps that are time consuming.
Depending on the organization, it seems there are a plethora of credentialing details that can hold up the process of gainful employment. We need better processes for credentialing, and it should not take more than two weeks to complete this process. I have heard of primary care providers being unemployed for 6 months to a year due to credentialing barriers. This is silly and not necessary.
I could not upload a pdf or word file of the email message since you restrict uploads to photos of videos. How can we do what you recommend, "copy of the email correspondence or chat" if you restrict formats?

Online registration is terrible! I have a mac and tried to use this to get registered online. A very unhelpful helpdesk lady told me that their software is not compatible with mac's and I needed to get a pc. Buy a new computer? That's your solution? This company is the worst and I hope I never have to use them again. I would rate it 0/5 stars for helpfulness.

I can't tell if this web-based company is legitimate. I got an email from them asking me to update my personal credentialling information. I called them and spoke with someone named 'BJ". I told him that first, I don't recall setting up any credentialing database with them. He told me that it could be a hospital who sent this. I asked which hospital and he proceeded to ask questions to verify my identity. This is where things get suspicious. He asked for my SS # which I refused to give him. Then he asked for my DEA #. Since that is public information based on my name, I gave that to him. Still he needed more personal information which I refused. So he asked me to answer a "security question" which was "which city did you go to for your honeymoon?". I know for sure that is not one of the questions I've ever answered for a security question because I went to two cities. I argued with him that this is not a legitimate question and since I already gave him my DEA number and he can easily verify my name with that number, it would have been easy for him to tell me which hospital submitted my info into their website. I told him I would call that hospital to verify that indeed they submitted my information. He refused to tell me. This is a very suspicious website asking for personal information and until the company provides more avenues to verify that they legitimate and not a scam, I will not work with them. Beware of ID theft with this company.

The new application/webpage for keeping provider data current has a flaw. It asks for hospital affiliations/privileges and many providers are office-based only, using an admitting agreement with a local hospitalist group. There is no option to input this type of arrangement, but there should be. When speaking to your reps, they then request the Tax ID of the hospitalist group, but we cannot get that, in most cases.

This is a catch-22 for most records we are currently updating, but a very common arrangement in the real business world, for private practitioners. Not all providers work in hospitals, nor do they need hospital privileges. Please consider having your web page programmers improve this section.
Thank you

What a miserable company! I was required to fill out a physician profile at CAQH Proview for a job that I applied for. The computer program was very poorly designed and cumbersome to fill out. This company apparently is allied with an insurance company, and the company tries to make the applicant available for insurance marketing even as they are collecting credentialing data. Then, they try to make the applicant provide data on all the professionals who work with you! (Their website reads, "CAQH ProView is more than a credentialing database. Available at no cost to you...". It appears to be a tool to coerce applicants to reveal information for use in marketing schemes.)The company staff were not able to answer even the simplest of questions. Emailed questions received vague and nonsensical responses, and even for that I had to wait one week. Avoid them if you can!

I am a sole professional who recently started accepting Anthem BCBSNH insurance. I am trying to set up EFt payments as I have with other insurance. Those took 2 days...I filled out info, they sent trial pay'ts to my CU, and I am receiving payments.
Anthem uses CAQH, with which I am already registered as a provider. To get EFT payments, I not only have to set up EFT but ENROLL! This has been a disaster. Because my "professional' name is slightly different (uses my middle initial) than my CU acct. the name the CU officer wrote was slightly different. It took some time to get htem to jive.
Now, they have been calling me (once at 7AM! and another in the evening...when I see clients) and told me that I must respond by PHONE within a business day to verify info!
I have tried for TWO days to call and just get a recording for over ONE HOUR each time! I have emailed them and get back a canned response that I must verify by phone. Today they sent an email saying my verification FAILED!
They just contacted me again and they continue to give me the same phone number where NO ONE actually answers, but the recording for over 1 hour with 'we have an unusually high number of calls...et al"/
I can find no MAIN number to call, as when I do, everyone says they have nothing to do with enrollment. This is an impossible NO WIn and should be looked into. and I want this resolved
I have given them a time window in which to calll me, but I have no hope of them doing so