Provider Directory Information Will be Verified through the CAQH Directory Management Solution Starting January 1

As we mentioned in the November Provider News email, Highmark Wholecare will begin to use the CAQH Directory Management Solution to manage the provider directory attestation process starting January 1*. This transition to CAQH will help simplify the attestation process for providers.

Our providers must already attest that their provider directory information is correct every 90 days, according to CMS and DHS requirements. This new process will ensure we can access your information for our directory so that our members can easily find you. Providers should perform the following tasks starting January 1, 2025:

1. If you already are registered with the CAQH Provider Data Portal, Login Here and ensure that Highmark Wholecare is authorized to receive your information on the Authorize tab.

OR

If you are new to the CAQH Provider Data Portal, Register Here. You will then need to gather credentialing information and Login to complete your profile and upload needed documents. Be sure that Highmark Wholecare is authorized to access your information on the Authorize tab.

Attestation information, including your current Provider Status, is displayed directly below the top navigation menu for new users. Upon your first login, first complete your Profile Data, then review and attest.

2. Help Patients Find You: You will receive a “Help Patients Find You” banner notification on the Home tab or an email notice if you have new addresses to accept or reject. These new addresses occur when the provider directory data you have documented in CAQH differs from what Highmark Wholecare has on file. Please click the notification to confirm the new address, reject the new address, or add corrections to address, phone number, email address, fax number, and any other directory information.

3. Re-Attesting: Every 90 days, you will need to re-attest to your provider directory information. The notification directly below the top navigation menu will let you know how many days until your next attestation must be completed. Please promptly review and attest, to ensure we have accurate directory information for you.

If you have any questions, please review the CAQH Provider Data Portal User Guide on your login page, visit the Help page, or contact CAQH through their live chat or by calling 888-599-1771, Monday – Friday, 8 a.m. – 5 p.m.

Thank you for helping us ensure our members have access to the care they need!

*If you have a delegated credentialing relationship with us, there will be no need to log into CAQH. Please continue with your current roster process.