The CAQH Setup Guide for New ABA Practices

Most credentialing delays don’t start at the payer — see our complete credentialing roadmap for the full picture. They start at CAQH.

CAQH ProView is the universal data repository that most commercial payers use to verify provider credentials. If your CAQH profile is incomplete, inconsistent, or unattested, the applications you submit to Aetna, UnitedHealthcare, Cigna, Humana, and their peers will stall — often without a clear error message telling you why.

This guide walks through the setup process step by step, with specific attention to the mistakes new ABA practices make most often.

What CAQH ProView Is (and Isn’t)

CAQH ProView is not a payer application. It’s a shared data repository. Think of it as a verified source of truth about your credentials — one that payers can pull from instead of asking you to fill out separate forms with the same information over and over.

Over 1,000 health plans participate in CAQH ProView — including Cigna, UHC, and other major commercial payers. ¹ When you authorize a payer to access your profile, they pull your credential data directly. That’s the upside. The downside: if your profile is wrong, every payer that pulls from it gets the same wrong data.

Setting it up correctly the first time saves weeks of deficiency letters downstream.

Before You Log In: Gather Your Documents

You’ll need these on hand before you start. Trying to complete CAQH without them means saving an incomplete profile and coming back — which wastes time and creates version-control confusion.

Professional credentials:

BCBA certificate (from the BACB — not your supervision agreement, not your university diploma)
State license(s) — behavior analyst license, LABA, or equivalent in states that require it
If dually licensed (LCSW, LPC, etc.), include all active licenses

Business and entity information:

EIN (Employer Identification Number) for your practice entity
Type 2 NPI for the practice
Type 1 NPI for you as an individual provider
Business address and mailing address (these can differ)
Practice phone and fax numbers

Malpractice/liability insurance:

Certificate of Insurance (COI) showing your professional liability coverage
Coverage dates, policy number, and carrier name
Retroactive date (also called prior acts coverage) — payers will ask for this
Per-claim and aggregate limits — minimums vary by payer, typically $1M/$3M

Work history:

Employment history for the past 10 years, with exact dates (month/year), addresses, and supervisor names where applicable
Gap explanations for any periods of non-employment longer than 30 days

Education and training:

Graduate degree conferral documentation (official transcript or diploma)
BCBA certification date
Any subspecialty training or certifications relevant to your practice

Step-by-Step: Creating Your CAQH Profile

Step 1: Register at proview.caqh.org

Go to proview.caqh.org and select “New Registration.” Enter your Type 1 NPI — this is how CAQH locates you in their system. You’ll receive a CAQH ID and a temporary password by email within a few minutes.

If you’ve previously been employed at a group practice that used CAQH, your profile may already exist with a prior CAQH ID. Search for it before creating a new one. Duplicate profiles cause complications.

Step 2: Complete the Provider Profile — All Sections

CAQH organizes the profile into sections. Complete every one, even the sections that seem not to apply. Leaving a section blank or marking it “not applicable” without explanation is different from documenting that an item is genuinely not applicable. Payers see the difference.

Key sections:

Personal information: Legal name exactly as it appears on your BCBA certificate and state license. No nicknames, no middle-initial variations. If your license says “Jennifer,” don’t use “Jen.”

Professional IDs: Enter both your Type 1 NPI and Type 2 NPI here. Also enter your Medicare PTAN if you have one (you’ll need it for any Medicare-adjacent billing), your Medicaid provider number if already assigned, and your DEA number if applicable.

Education and training: Credential each degree separately. Include the institution’s full legal name, address, degree conferred, and date of conferral. Upload the transcript or diploma as a PDF.

Work history: List every position for the past 10 years in reverse chronological order. Use exact dates. Include your current practice, even if it’s new. Document any gap months explicitly — “transitioning between positions,” “practice setup period,” or similar.

Professional liability (malpractice): Enter policy details and upload the COI. CAQH will flag expired coverage automatically, so upload a fresh COI at renewal every year.

Hospital affiliations: If you have none, document “No hospital affiliations.” Do not leave the section blank.

Disclosure questions: These are the yes/no questions about license sanctions, malpractice judgments, and criminal history. Answer accurately. CAQH cross-references these against public databases. Inconsistencies trigger manual review.

Step 3: Upload Supporting Documents

Every section that requires documentation needs the actual file attached — not just the data fields filled in. Payers frequently request documents directly from your CAQH profile during credentialing. If the document isn’t there, you’ll get a deficiency letter.

Upload as PDF where possible. Clear, legible files only. Scanned documents that are blurry or cut off at the edges are functionally useless to a credentialing reviewer.

Step 4: Authorize Payers to Access Your Profile

Once your profile is complete, go to the “Authorize” section and grant access to each payer you’re applying with. This is a step many providers skip or do out of order — submitting payer applications before the CAQH authorization is in place. The payer receives the application but can’t pull your data. Nothing moves.

Authorize payers before or simultaneously with submitting applications.

Step 5: Attest

Attestation is the formal certification that your profile is accurate and complete. CAQH requires re-attestation every 120 days. The first attestation also starts the clock.

Submit your first attestation only when the profile is genuinely complete. A premature attestation followed by immediate profile edits can create inconsistencies that some payer systems flag.

Re-Attestation: Do Not Miss the 120-Day Window

CAQH sends email reminders at 90 days and again at 110 days. If you miss the 120-day window, your profile lapses. Payers that try to pull your data get an error state, not your credentials.

In the credentialing context, a lapsed CAQH profile can stall a pending application, trigger a payer’s “provider data not available” deficiency, or, in the worst case, initiate de-credentialing with a payer you’re already contracted with. ²

Set a recurring calendar event. Treat the 120-day window as a hard deadline.

Common Mistakes That Delay Credentialing

Name inconsistency. The name on your CAQH profile must match your state license, your BCBA certificate, and your NPI registration. If your license says “Smith-Jones” hyphenated and your NPI says “Smith Jones” without the hyphen, you’ll get a deficiency letter. Fix it before you apply.

Expired documents. Malpractice COIs expire. State licenses expire. BACB certificates are continuous but check the renewal date anyway. Uploading an expired document is worse than uploading none — it tells the payer your coverage lapsed.

Incomplete work history. “I’ve been self-employed for three years” is not sufficient. Document the practice name, address, start date, and your role. If your practice is new, document the start date and note that you’re the owner.

Wrong taxonomy code. Your CAQH profile should reflect your primary taxonomy code. For BCBAs, the correct CMS taxonomy is 103K00000X (Behavior Analyst). Using a wrong or generic taxonomy code can mismatch your billing profile with your credentialing profile. ³

Not updating after life changes. New state license? New liability carrier? Practice address change? Update CAQH immediately. Stale data flows downstream to every payer that has pulled your profile.

CAQH Is Infrastructure, Not a One-Time Task

Most providers treat CAQH as something they set up once and forget. That’s how profiles lapse and how credentialing gaps happen at renewal.

Build a simple maintenance routine: check the profile quarterly, re-attest on schedule, and update documents within one week of any credential change.

Get This Right From the Start

A clean CAQH profile is the foundation of a clean credentialing process. It’s not glamorous work. But getting it wrong costs weeks — sometimes months.

ABA Practice Services handles CAQH setup, ongoing maintenance, and the full credentialing process for new ABA practices through our credentialing services. We make sure your profile is complete, consistent, and never lapses.

Book a free 30-minute consultation at abapracticeservices.com.

References

Council for Affordable Quality Healthcare. About CAQH ProView. CAQH.org. Accessed 2024. https://www.caqh.org/solutions/caqh-proview ↩
Council for Affordable Quality Healthcare. CAQH ProView Provider User Guide. CAQH.org. Accessed 2024. https://proview.caqh.org/uw/help/ ↩
National Uniform Claim Committee. Health Care Provider Taxonomy Code Set. NUCC.org. Accessed 2024. https://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40 ↩