This presentation provides an overview of CAQH ProView Practice Manager and explains how healthcare organizations can use it to manage provider and practice information in one centralized system. CAQH, the Council for Affordable Quality Healthcare, is a nonprofit organization that created a technology platform for provider data collection. The purpose of CAQH ProView is to reduce duplicate paperwork, improve data accuracy, and make credentialing and payer enrollment more efficient. The presentation introduces several CAQH tools, including CAQH ProView, the Practice Manager Module, CAQH ProView for Groups, DirectAssure, VeriFide, SanctionsTrack, and other credentialing solutions.
A main focus of the presentation is the five-step Practice Manager process: registering with CAQH ProView Practice Manager, completing practice or organization information, searching for and adding providers, managing and exporting information to provider profiles, and maintaining updated data. These steps are important because payer enrollment and credentialing rely on accurate provider information. If information is missing, outdated, or inconsistent, organizations may experience delays in credentialing, enrollment, payer approvals, or provider directory updates.
The presentation also walks through registration and account setup, including practice information, user information, account information, and dashboard navigation. It shows how practice managers can create and manage practice lists, enter organizational details, add credentialing contacts, and organize provider records. This is especially useful for organizations that manage multiple providers, practice locations, departments, or payer relationships.
Another major topic is practice location management. The presentation explains the types of information that must be entered for each location, including office type, address, Type 2 NPI, Medicaid and Medicare numbers, phone numbers, tax information, office hours, patient information, coverage contacts, accessibility, services, and practice limitations. This shows that CAQH ProView is not only a provider profile tool, but also a system for managing detailed location-level data.
Overall, this presentation teaches healthcare administrative professionals how CAQH ProView Practice Manager supports credentialing, payer enrollment, provider directory accuracy, and compliance. The main takeaway is that maintaining CAQH data is an ongoing responsibility, not a one-time task. When used correctly, CAQH ProView helps organizations centralize provider data, reduce errors, improve communication with payers, and prevent delays in enrollment and reimbursement.
Learning Objectives:-
Areas Covered:-
Why Should You Attend:-
Learn how to efficiently manage provider data within CAQH ProView, streamline credentialing workflows, and ensure accuracy across payer networks. This session will help practice managers and credentialing professionals optimize their use of CAQH tools to reduce administrative burdens and improve data integrity.
Who Should Attend:-
Yesenia Servin CPMSM, PESC is an expert in credentialing and provider/payer enrollment with over 23 years of experience in the healthcare industry. Yesenia has a deep understanding of Medicare & Medicaid enrollment and is a nationally certified credentialing manager and provider enrollment specialist. Through, YS Credentialing PLLC, Yesenia helps organizations develop and implement best practices guidelines, and processes. Guides the credentialing and payer enrollment structure. Thrives on training and growing administrative, credentialing, and enrollment healthcare professionals.
Yesenia manages payer enrollment, keeps team members and colleagues up to date on industry trends, and is a liaison to all departments that impact payer-enrollment processes. Yesenia works with durable medical equipment, hospitals and health systems, and community mental health organizations, global managed care organizations as well as providing revenue cycle consulting services to various healthcare providers and organizations.
Yesenia is a current CharterOak University Faculty, a NAMSS member, and is a past NAMSS Educational Conference Guest Speaker, a current member of the NAHRI Leadership Council, a current trainer for The Chicago School of Professional Psychology trainer, and a TMG Collaborator. Yesenia studied microeconomics and communications at NEIU and healthcare administration at Concordia University Chicago.