If you take only one thing away from this post: the most expensive mistake in dental credentialing is a stale or incomplete CAQH ProView record. We’ve seen single CAQH typos add 6 weeks to an enrollment timeline. We’ve seen entire applications rejected because a malpractice carrier letter expired 11 days before submission.
CAQH ProView is the central credentialing application database used by most US dental payers (and almost all medical payers). Instead of filling out a separate application for every plan, you complete one standard profile, and payers pull from it. In theory, this saves time. In practice, every payer also runs their own primary source verification (PSV) on top of your CAQH data — meaning any inconsistency between CAQH and source documents creates a manual review, which means your application sits in a queue.
Why CAQH stalls applications
Three reasons, in order:
- Stale attestation.CAQH requires re-attestation every 120 days. If your last attestation is older, payers won’t pull from your record at all.
- Field/source mismatch.The address on your CAQH profile doesn’t exactly match the address on your NPI registration, or your malpractice carrier’s name on CAQH doesn’t match the carrier’s letter.
- Missing supporting documents.CAQH lets you attest without uploading the supporting PDF. Payers don’t. They’ll auto-bounce the application back.
The new-provider CAQH checklist
Walk through every section of CAQH ProView with this checklist before you mark your profile attested. We’ve seen at least one dental provider stall on every single one of these.
1. Personal information
- ✓Legal name matches your dental license exactly (including middle initial and any suffixes like Jr., DDS, DMD).
- ✓SSN matches IRS records — if you’ve changed it via marriage/divorce, ensure SSA records are updated first.
- ✓DOB on CAQH matches DOB on every license, NPI record, and DEA registration.
2. Practice locations
- ✓Primary practice address matches NPI Type 1 (individual) and Type 2 (organization) records byte-for-byte. “Suite 100” and “#100” are not the same to a payer.
- ✓Phone numbers are direct lines that ring at the practice — payer verification calls bounce when they hit a switchboard or personal cell.
- ✓Hours of operation match what’s on Google Business Profile and the practice website. Yes, payers cross-reference.
3. Education & training
- ✓Dental school name, address, and graduation date match the transcript on file. Schools change names — “UCSF School of Dentistry” and “University of California San Francisco School of Dentistry” are different strings.
- ✓Residency or specialty training (if applicable) has both start and end dates filled in.
4. Professional IDs
- ✓NPI Type 1 (individual) is uploaded and matches NPPES exactly.
- ✓NPI Type 2 (organization), if you bill under an org TIN, is uploaded and the TIN matches IRS records.
- ✓DEA registration uploaded with current expiration date (only if you prescribe).
- ✓State dental license is uploaded with expiration date at least 90 days in the future. Payers reject licenses expiring within 60 days.
5. Malpractice insurance
- ✓Carrier’s formal coverage letter, not the policy declarations page, is uploaded. The letter must be on carrier letterhead and reference your name + policy number.
- ✓Coverage limits are at or above the typical $1M/$3M minimum (most dental payers require this).
- ✓Effective and expiration dates are inside the next 90 days, not ending tomorrow.
6. Disclosures
- ✓Every “Yes” answer to a disclosure question (board actions, malpractice claims, exclusions, criminal history) has a corresponding explanation document uploaded — even if the incident was 20 years ago and resolved.
- ✓All “No” answers are answered. CAQH lets you skip them; payers treat skipped questions as a red flag.
7. Authorization & attestation
- ✓CAQH Authorization is granted to everypayer you intend to enroll with. Default is “Authorize Selected Plans Only.” Many providers leave this and wonder why payers can’t see their record.
- ✓Attestation is dated within the last 30 days when you submit payer applications (CAQH allows 120 but payers reward fresh).
What OneExpert does to your CAQH
When you onboard with OneExpert, our system runs a 47-point consistency check across your CAQH profile, NPI records, malpractice documents, and dental licenses before any payer submission. We catch the address-format mismatch, the typo in your dental school name, the malpractice expiration that lands inside your enrollment window. Then a human reviews the diff and confirms.
If you’re managing CAQH manually, the checklist above is the shortest path to getting your first payer enrollment off “pending” status.