CAQH
CAQH runs the shared credentialing data source many commercial payers pull from — one profile a provider maintains, rather than one application per payer.
Updated
CAQH — the Council for Affordable Quality Healthcare — operates the provider data source a large number of commercial payers use for credentialing. Rather than each payer collecting the same education, licensure, and work history separately, a provider maintains one profile and authorizes payers to read it.
Its constituency is worth knowing. CAQH was formed by health plans, and in January 2026 it converted from a not-for-profit to a for-profit company owned by shareholders affiliated with large health plans. That does not make the profile less useful — but it does explain whose problem it was built to solve, which is a reasonable thing for a provider to understand about the system holding their credentials.
The organization has rebranded as DataSpring: caqh.org now resolves to dataspring.com, which describes itself as “DataSpring, powered by CAQH.” The credentialing profile, historically known as CAQH ProView, is now the Provider Data Portal. In practice the industry still says “your CAQH,” and payers still ask for a CAQH ID — so both names are worth recognizing.
In practice
The thing to understand about CAQH is what it is not. It is a data source, not an approval: a complete, current, attested profile does not credential anyone. Payers still make their own decisions on their own timelines, and a provider whose CAQH is immaculate can still be un-enrolled with every payer they see patients for.
Its failure mode is quiet. A profile must be re-attested periodically, and one that lapses can stop payers from pulling current data — which surfaces later as a credentialing application that stalls for a reason nobody at the practice can see, because nothing about a lapsed attestation announces itself.
Commonly confused with
- Credentialing: CAQH supplies the data; credentialing is the payer's verification and decision. Having a profile is not being credentialed.
- PECOS: PECOS is Medicare's own enrollment system. CAQH is used by commercial payers. Medicare does not credential from a CAQH profile.