Your providers’ CAQH profiles are one missed attestation away from a network termination
We manage CAQH maintenance for PT, OT, and SLP practices so your providers stay in-network, your claims keep paying, and your front desk stops playing credentialing air traffic control.
The silent killer of in-network revenue
CAQH is not a one-time task. Every provider must re-attest every 120 days (180 in Illinois), keep every document current, and confirm every practice detail is accurate. Miss the window and the profile goes Expired. Let a malpractice COI lapse inside the profile and the attestation is worthless even if you signed it yesterday.
When that happens:
Payers can't pull current data, so recredentialing stalls.
Claims start denying with "provider not credentialed" codes.
Payers can terminate the contract. Re-credentialing takes 90 to 120+ days.
Patients get rescheduled, sent out-of-network, or lost.
Nothing is retroactive. Denials during the lapse stay denied.
Most practices ask providers to manage their own CAQH. It fails the same way every time: the clinician has five patients back-to-back, the reminder email gets buried, and nobody finds out until a denial batch lands three weeks later.
Built for Therapy Practices.
Generic credentialing shops treat outpatient therapy like an afterthought. We don’t do anything else. Prime Credential is a pure-play credentialing and payor enrollment company built exclusively for PT, OT, and SLP practices. We know which commercial payers pull CAQH weekly, which ones pull at recredentialing only, and which taxonomy and specialty fields trip up therapy providers specifically.
What We Maintain in Every CAQH Profile
We own the profile end-to-end. Every 120 days, on schedule, with documents verified against primary source before attestation. We keep the following current and aligned with NPPES, your W-9, your state license board, and your payer rosters:
Practice locations and contact info
Addresses, phone, fax, email, office hours, and languages spoken at each location.
Accepting new patients status
Availability kept accurate so payer rosters and provider directories stay up to date.
Malpractice history and disciplinary actions
Claims history, board complaints, sanctions, and Medicare/Medicaid exclusions on record.
Supporting documents & credentials
W-9, COI, license copies, board certs, and CV refreshed before each attestation cycle.
Professional licenses & certifications
State licenses, CPR/BLS, and board certs — renewed copies uploaded before expiration.
Facility and group ownership changes
Tax ID, NPI Type 1 and 2, and Medicare/Medicaid numbers updated as changes occur.
Re-attestation every 120 days
Logged in and re-attested on schedule — a stale profile means payers stop pulling it.
Professional liability insurance
COI with effective dates, expiration, coverage amounts, and carrier.
Specialties, programs, and taxonomy codes
Services, specialty designations, and taxonomy codes aligned with your payer records.
Four steps
You stop thinking about CAQH
Report
You get a dashboard and a monthly summary. Every provider’s status, every upcoming expiration, every action taken.
WHO THIS IS FOR
Built for outpatient therapy
PT, OT, and SLP private practices, single-location or multi-site
Group practices and regional chains
Practices with 3 to 300+ providers
Practices onboarding new clinicians and wanting CAQH handled from day one
Practices that have been burned by a missed attestation and are not going back
WHAT TRIGGERS AN UPDATE
We don’t wait for the 120-day clock
New clinic location, closed location, or changed billing address
A provider’s license renews, expires, or changes status
Malpractice policy renews or carrier changes
A board complaint, malpractice claim, or sanction is filed or resolved
Your TIN or entity structure changes
A provider starts or stops accepting new patients
OUTCOMES
When we run your CAQH
Zero expired profiles across your roster
No recredentialing delays caused by CAQH data gaps
Fewer “provider not credentialed” denials
Front desk and clinical staff stop chasing attestation reminders
Predictable revenue, because your providers stay in-network
Clean audit trail for payer and regulatory reviews
THE REAL COST OF DOING IT YOURSELF
The Math on D.I.Y.
Prime Credential Managed
- Dedicated credentialing team with backups
- Tracked in our platform with 120/60/30/7-day alerts
- Documents refreshed before expiration
- Full reconciliation against every source of truth
- Discovery of risk = fixed before payer sees it
- Dashboard showing every provider’s attestation status
With Prime Credential
Prime Guard
$21.95per provider every month
Enjoy the following benefits:
CAQH Maintenance – Ongoing upkeep and re-attestations managed on behalf of all providers; clients are notified and providers prompted when action is required.
Certificate of Insurance (COI) Tracking – Monitored for expiration with proactive outreach to ensure coverage never lapses.
License Management & Tracking – Monthly license verification against state licensing boards for all active providers; proactive alerts for any status changes or impending expirations.
Proactive Notifications – Clients are alerted well in advance of upcoming recredentialing windows, so nothing catches you off guard.
Prime Compliance
$28.95per provider every month
Everything on Prime Guard, plus the following:
Monthly OIG Exclusion Check – Verifies providers are not excluded from participation in federal healthcare programs via the HHS Office of Inspector General exclusion database.
Monthly SAM Check – Confirms providers are not listed on the System for Award Management (SAM.gov) exclusion database, which covers federal contracts and programs.
Monthly Medicare Exclusion Check – Checks CMS databases to ensure providers remain eligible to bill Medicare and have not been debarred or excluded.
State License Exclusion Check – Confirms providers hold active, unrestricted licenses in their practice states and have no disciplinary actions or restrictions on file.
Prime Guard
$219.50per provider every month
Enjoy the following benefits:
CAQH Maintenance – Ongoing upkeep and re-attestations managed on behalf of all providers; clients are notified and providers prompted when action is required.
Certificate of Insurance (COI) Tracking – Monitored for expiration with proactive outreach to ensure coverage never lapses.
Recredentialing Tracking & Submissions – Managed per each payer’s cadence. We track all recredentialing cycles and initiates submissions proactively without requiring reminders.
Proactive Notifications – Clients are alerted well in advance of upcoming recredentialing windows, so nothing catches you off guard.
Prime Compliance
$289.50per provider every month
Everything on Prime Guard, plus the following:
Monthly OIG Exclusion Check – Verifies providers are not excluded from participation in federal healthcare programs via the HHS Office of Inspector General exclusion database.
Monthly SAM Check – Confirms providers are not listed on the System for Award Management (SAM.gov) exclusion database, which covers federal contracts and programs.
Monthly Medicare Exclusion Check – Checks CMS databases to ensure providers remain eligible to bill Medicare and have not been debarred or excluded.
State License Exclusion Check – Confirms providers hold active, unrestricted licenses in their practice states and have no disciplinary actions or restrictions on file.
Stop managing CAQH. Start knowing it’s handled.
Book a complimentary CAQH Double Check. You’ll receive an expert evaluation of your current workflow, identifying procedural gaps and areas where your network participation may be at risk.
No cost, no obligation.