Fillable CAQH Provider Application


(4.5 / 5) 85 votes
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Get your CAQH Provider Application in 3 easy steps

  • 01 Fill and edit template
  • 02 Sign it online
  • 03 Export or print immediately

What is a CAQH Provider Application? 

CAQH stands for ‘Council for Affordable Quality Healthcare,’ a non-profit organization based in California. The CAQH application PDF allows you to register as the provider. 

What I need CAQH provider application form for? 

You need to apply for a provider in the following cases:

  • To get access to your information to insurance companies;
  • To make the provider’s information more efficient. It means that insurance companies can just go to the CAQH website and get all the needed information about you instead of calling your office to know the work history and copy the medical licenses. 

Filling out CAQH Application Form 

The CAQH form is pretty long, about 17 pages with lots of blank fields. Here are some basic rules:

  • Use only сapital letters;
  • Use the cross to indicate the correct answer, not dot or any other sign. 
  • The form has several sections:
  • Personal info along with your IDs;
  • Education/Training;
  • Professional/Medical specialty information;
  • Practice location information;
  • Hospital affiliations;
  • Professional liability insurance carrier;
  • Work history and several references from your employer;
  • Questions concerning the information disclosure. 

Also, on the bottom of the document, you’ll find Standard Authorization, Attestation and Release page. You need to read it very attentively and put a signature and the date at the end of the page. In addition, there are code lists and special boards.

Organizations that work with CAQH form

Council for Affordable Quality Healthcare. 

Relevant to CAQH Form Documents

FAQ: CAQH Application PDF Popular Questions

  • How to get a CAQH number?

    A CAQH number can be obtained by contacting CAQH at 888-599-1771 or by visiting their website at Another way to get it is by clicking the "Fill this form" button on this page.

  • What is CAQH number?

    A CAQH number is a unique identifier assigned to a health care provider by the CAQH, a not-for-profit organization. The CAQH number is used by health plans and health care providers to streamline the provider credentialing process.

  • How do I find my CAQH provider ID number?

    You can find your CAQH ProView ID number in the upper-right corner of your profile.

  • How to fill out CAQH provider application online?

    There is no one-size-fits-all answer to this question, as the process for filling out a CAQH provider application online may vary depending on the specific provider and the type of application being completed. However, in general, most CAQH provider applications can be completed online by following the instructions on the provider's website or by contacting the provider directly.

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Fillable online CAQH Provider Application
(4.5 / 5) 85 votes
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