CAQH ProView is the closest thing the US healthcare industry has to a shared credentialing record, one profile that dozens of payers read instead of asking you for the same documents again. It is also the single most common reason an otherwise complete credentialing application stalls in a payer’s queue. The cause is almost never a missing document. It is a lapsed attestation.
What this covers
- CAQH asks for a review and re-attestation at least every 120 days.
- Payers generally will not rely on data attested longer ago than that.
- Nothing is deleted when it lapses. Applications simply stop being actionable.
- Delegation settings decide who can maintain the profile, and they need auditing too.
Most practices treat ProView as a one-time setup task. It is not. CAQH asks providers to review and re-attest their profile on a rolling cycle, and payers generally will not rely on data that has not been attested recently. When that window closes, every application that depends on the profile quietly stops progressing, and nothing in your inbox tells you that is what happened.
What CAQH ProView is, and what it is not
ProView is a credentialing data repository operated by the Council for Affordable Quality Healthcare, a non-profit alliance of health plans. A provider completes one standardized application covering licensure, education, training, work history, malpractice history, hospital affiliations and practice locations. Participating payers then read that record instead of collecting the same information individually.
Three distinctions matter, because they explain most of the confusion in practice:
- It is not a payer. Attesting in ProView does not enroll you anywhere, and it does not mean you are credentialed. It means your data is available and current for the payers that use it.
- It is not an accreditation or a certification. It is a record. Its value is that payers accept it in place of their own intake process.
- It is not automatic. Someone has to keep it accurate. That someone is usually a practice manager who already has eleven other calendars.
The 120-day clock
CAQH asks providers to review and attest to the accuracy of their profile at least every 120 days. Payers, in turn, generally require an attestation no older than 120 days when they pull the data, which means the profile has a shelf life rather than a completion state.
Re-attestation is not a button that says “still correct”. You are asked to review each section and confirm it. that is what matters: the record is meant to reflect the provider as they are now, so re-attestation is where changes normally surface, a new practice location, a lapsed DEA registration, a malpractice claim that was open at the last attestation and is now closed, an added hospital affiliation, an NPI taxonomy that no longer matches the work.
Credentialing decisions are made on the assumption that the data is current. A payer that relies on a nine-month-old attestation to approve participation has approved a provider on the basis of information nobody has verified since then. The 120-day cycle exists so the shared record stays trustworthy enough to replace individual intake, and that trust is exactly what a lapse suspends.
What actually happens when it lapses
There is no dramatic failure. Nothing is deleted, nothing is cancelled, and no letter arrives announcing a problem. What happens is quieter and more expensive:
- Payers stop treating the record as usable. An application sitting with a plan that pulls CAQH data can be pended or returned because the attestation is out of date. It is not denied for cause, it is simply not actionable.
- The application loses its place in the queue. Payer credentialing queues are worked in order. A file that goes back to the applicant re-enters later than it would have, which moves the effective date rather than just the submission date.
- Everything downstream slides. In a multispecialty group adding three clinicians, a lapsed profile in month one affects the effective dates that billing has already planned around, and the revenue forecast that assumed those providers would be billable from a specific week.
- Nobody notices until someone asks a question. The lapse typically surfaces when a practice chases a stalled application and is told the profile is stale, weeks after the delay began.
The fields that go stale first
| Profile section | What changes without anyone thinking about credentialing |
|---|---|
| Practice locations | A new office, a closed satellite, or a suite renumbering that was reflected in the EMR but nowhere else |
| Licences and DEA | Renewal dates move annually or biennially, and a pending renewal still has to be reported accurately |
| Malpractice history | Suits opened, closed, settled or dismissed since the last attestation, the section payers read most closely |
| Work history | An unexplained gap or a missing start/end date triggers a query later, which restarts the clock on that application |
| Hospital affiliations | Privileges granted, lapsed or resigned; often managed by a separate office entirely |
| Taxonomy and specialty | A subspecialty added, or a taxonomy that no longer matches the services actually being billed |
Delegation is the trap nobody checks
ProView lets a provider authorize other organizations, a credentialing service, a CVO, a health system, a billing company, to access and, in some configurations, to maintain the profile on the provider’s behalf. That authority is finite and revocable, and when it lapses or is granted incorrectly, the result looks like a stalled application rather than a permissions problem.
Two failure modes show up repeatedly. First, delegation was set up years ago with an organization the practice no longer uses, and nobody removed it, so the wrong party is still authorized on a live, sensitive record. Second, delegation was never set up at all, so the person who is supposed to manage credentialing cannot actually act on the profile, and spends the 120-day window asking a busy physician to log in and attest.
When you audit the profile, audit who can see and touch it. A profile that is accurate but delegated to the wrong organization is a data-governance problem today and a delay tomorrow. Confirm the delegation list reflects the parties actually involved in your credentialing.
The rhythm that works
Attestation is not hard, and it is not slow, it is dated. What keeps it current is a process, not diligence:
- A 120-day calendar entry per provider, not a single reminder for the practice. Profiles expire individually.
- An internal review before attesting. Never re-attest without checking the six sections above. Re-attesting stale data is worse than a visible lapse, because it certifies information that is wrong.
- Attestation tied to every other change. Moving office, adding a location, a new licence, a new hospital affiliation or a malpractice event all mean the profile changes, and the attestation should follow the change rather than wait for the cycle.
- Delegation verified once a year against the organizations actually doing credentialing work for the practice.
- The profile treated as a source, not a copy. Payers pull from it, so errors in it become errors in six payer files instead of one.
This is the part of credentialing that never finishes, so it belongs to a standing process rather than a project. It is also why the same calendar has to hold Medicare revalidation, commercial recredentialing and payer-specific re-attestations, see our credentialing and payer enrollment services for how those cycles are tracked together, and what happens to effective dates when they are not.
Before you attest, check these
If you are doing a profile review this month: confirm the practice locations match the enrolment records on file with each payer, confirm licence and DEA expiry dates, read the malpractice section against what you know has happened since the last attestation, check for unexplained work-history gaps, and confirm the hospital affiliation list reflects reality. Then attest.
If a payer has told you an application is stalled and you suspect the profile, the fix is the same review, and then re-submission, which means the file re-enters the queue. That is a billing and enrollment timeline question as much as a credentialing one, so we check enrollment effective dates against claim history rather than leaving them in a separate spreadsheet.
Questions we get about CAQH
CAQH asks providers to review and attest at least every 120 days, and payers generally require an attestation no older than that when they use the profile for credentialing. Treat 120 days as the deadline for each individual provider, not a practice-wide date.
Nothing is deleted, but payers stop treating the record as usable. Applications that depend on it can be pended or returned, and when they are re-submitted they go to the back of that payer’s queue. The practical cost is a moved effective date and delayed revenue, typically discovered weeks after it started.
No. CAQH ProView is a shared credentialing data repository; attesting in it does not enroll you with any payer and does not make you in-network. It means participating payers can read current, verified information about you instead of collecting it themselves.
Yes, if the provider grants that access through ProView’s delegation and authorization settings. The provider remains accountable for the accuracy of the profile, so delegation is a permissions decision as much as a convenience one, and the authorization list should be reviewed and kept current.
If any payer you contract with uses ProView, yes, and that is most commercial payers. Existing participation does not remove the requirement, because payers re-verify data at recredentialing and when adding locations or providers. An unmaintained profile mostly causes problems at the moment you need something new approved.
They are three separate clocks on the same practice: CAQH attestation every 120 days, commercial payer recredentialing typically every three years, and Medicare revalidation at least every five years. Miss any one and claims can stop paying with no other change in your practice, so they belong on one calendar rather than three.
The bottom line
One date per provider, and a review before you attest rather than after a payer asks. Re-attesting stale data is worse than a visible lapse, because it certifies information that is wrong.
Whose job is the 120-day clock in your practice?
Send us your provider roster. We will check which profiles are current, which are stale, and which payers are already waiting on an attestation that has not happened, then tell you what to file and in what order.
Request a free credentialing reviewCAQH cycles, payer reliance rules and delegation settings can change, and individual payers apply their own requirements. Confirm current requirements with CAQH and with each payer before relying on this process description.
