Organization Profile

After you sign in to the CAQH Endpoint Directory, on the page Organization Profile, enter information on your organization that will be visible to healthcare organizations and by which they can search for your organization in the Directory.

The video tutorial is available on how to complete your organization profile as a health plan organization or as an application vendor.

Note Only an account administrator can work with the organization profile. If you do not have access permissions, contact your account administrator.

Note In the section Organization Profile, to edit the sections Organization Details and Contact Details, the user should be an EPD administrator as well as the account administrator of that certain organization.

Users with just the EPD Administrator role permissions can only edit the sections Supporting Documents, Order Form, and Attestation.

On the page Organization Profile, as an administrator, you can:

  • Enter organization details, such as organization's name, type, aliases, IDs, links, and so on.
  • Enter primary, secondary, business, technical, and support contacts.
  • Add all the supporting documentation, such as registration documents, and so on.
  • Add a signatory/attestor to sign your organization’s agreement with CAQH and to have a centralized signing for all the applications/endpoints.
  • Edit or update your organization profile information.
  • View the date and time when the organization profile has been last modified or saved.
  • View the name of the user who has last modified or saved the organization profile.

In the section Organization Profile, complete the following steps to prepare and publish your organization’s profile:

Tip You can use the table of contents on the left to switch between sections and fill them in any order.

  1. In Organization Details, enter the following information:
    • An image with your application's logo.
    • The organization name.
    • The organization type (payer, provider, logistics, employer, retailer, vendor, and other). If you select the type Other, in the field that appears, enter the type of your organization deciphering Other.
    • The organization aliases. The organization can have several aliases (alternative names) by which your organization can be searched.
    • The organization IDs (mandatory field), such as TIN (mandatory field), TAN, PAN, NPI, and the CAQH organization ID. Upload certain documents related to the Internal Revenue Service (IRS) registration for CAQH verification of the TIN ID.

      Note You will receive a notification if more than 30 days have elapsed since the completion of your profile but you have not still uploaded IRS documents for CAQH to verify. Once uploaded and verified by CAQH, an IRS Verified badge is applied to all the items displaying your organization and application details.

    • The organization's address, phone and fax numbers.
    • The link to the organization's website.
    • The Terms and Conditions URL to your organization's terms of service resource.
    • The Privacy Policy URL to your organization's privacy policy resource.
    • The Developer Portal URL where you can add the URL to the App Developer Portal for FHIR of your organization that is visible on the public page of your organization.
    • The Interoperability Solution Vendor (optional field) to help you (if you are a vendor organization) identify payer vendor communications and check how payers can communicate with your organization. The same works for you (if you are a payer) when you coordinate with the vendor organizations.
    • The short and extended informative descriptions of your organization.
  1. In Contact Details, enter the following contacts:
    • Primary Contact (this person enters organizational information, designates access, responds to connection requests): the first and last name of a first person responsible for all communication with your organization, his/her role, email, and the phone number.
    • Secondary Contact (this person is a designated backup for the primary contact, enters organizational information, designates access, responds to connection requests): the first and last name of a second person responsible for all communication with your organization, his/her role, email, and the phone number.
    • Business Contact (this person is a recipient of invoices and a point of a contact for a payment): the first and last name of a contact person for cooperation, partnerships, and so on, their role, the email, and the phone number.
    • Technical Contact (this person resolves issues experienced when connecting to Endpoint/Applications): the first and last name of a person to contact regarding technical matters, their technical role, the email, and the phone number.
    • Support Contact (this person is responsible for triage issues and work with help desk level support): the email address and phone number of your organization's support. Avoid adding the contact information of an individual as a support contact.
  2. In Supporting Documents, provide information related to your organization for the review process support, such as registration documents. CAQH/Edifecs reviews all the organizational information and may perform background assessments to ensure the completeness and veracity of the submitted information.
  3. In Order Form, to specify the terms and conditions between CAQH and your organization as a customer for the CAQH Endpoint Directory, provide information on a person who will be digitally signing your organization’s agreement with CAQH that you can download as a draft version in a PDF format. To add an organization signatory, next to Signature, click , and then, in Full Name, Title, and Email ID, enter the details of the person who will be signing the order form.

    Note Information on the signatory cannot be modified once saved. To change the signatory, initiate a new order form.

    After you have added the organization signatory, the order form is assigned the status Pending Org Signature. Once the status of the order form changes to Pending Org Signature, the order form is sent to the organization signatory through email to be executed using DocuSign.

    Note A CAQH administrator can send the DocuSign emails with an order form in any status to a signatory regardless of the organization profile status.

    After the organization signatory executes the order form, a link to this order form is sent in an email message to be used through DocuSign to the CAQH reviewers (CAQH Reviewer 1 and CAQH Reviewer 2) who have to accept the order form. After the CAQH reviewers have reviewed the order form, a CAQH signatory receives a link to review and approve the order form. When all the signatories and reviewers have accepted the order form, the order form's status changes to Accepted and Signed and the final copy of the order form is uploaded to the CAQH Endpoint Directory as a PDF document and is available to view, otherwise, the order form is rejected.

    You can initiate a new order form when the current order form is in one of the following statuses: Pending Org Signature, Pending CAQH Review, Pending CAQH Signature, Accepted and Signed, and Rejected. After you initiate a new order form, you will have to add an organization signatory again. Until the organization signatory is assigned, the order form status will be Draft.

    In Sign Order Form, click Send Order Form Link to Signatory via email. Two email messages with a link and an access code that allow the organization signatory to access and sign/decline the order form will be sent out.

    Note The order form is considered signed once the signatures and reviewers have accepted and signed the order form using the latest link generated by the CAQH Endpoint Directory system and is stored/tracked in a PDF format in the CAQH Endpoint Directory.

    Once the order form is accepted and signed, the signed copy of the order form is also sent to all the involved participants and to the list of recipients for a record keeping and notification purposes.

    Note that your organization’s 12-month initial term subscription start date is effective once the order form has been signed by your and CAQH signatories.

    The order form can be assigned the following statuses:

    • Draft: a signatory is yet to be assigned to the order form.
    • Pending Org Signature: the organization signatory has been assigned to the order form, but the organization signatory has not yet signed the order form.
    • Pending CAQH Review: the order form has been signed by the organization signatory and is waiting for CAQH review by CAQH Reviewer 1 and CAQH Reviewer 2.
    • Pending CAQH Signature: the order form has been reviewed by CAQH Reviewer 1 and CAQH Reviewer 2 and is waiting for CAQH signing by a CAQH signatory.
    • Accepted and Signed: all the signatories and reviewers (your organization signatory, the CAQH reviewers, and the CAQH signatory) have accepted and signed the order form.
    • Rejected: any of the signatories or reviewers (your organization signatory, the CAQH reviewers, and the CAQH signatory) has rejected the order form indicating the reason of rejection.
  4. In Attestation, to have the capability of centralized signing for all the applications/endpoints so that you do not need to attest an individual application or endpoint, provide information on an attestor to digitally attest that the individuals entering data into the CAQH Endpoint Directory are authorized to do so. Note that the attestor should have the authority to attest on behalf of your organization. You can download the organization’s agreement with CAQH as a draft version in a PDF format. To add an attestor, next to Attestor, click , and then in Full Name, Title, and Email ID, enter the details of a person who will be signing the attestation document.

    Note Information on the attestor cannot be modified once saved. To change the attestor, initiate a new attestation.

    After you have added the attestor, the attestation document is assigned the status Pending Org Signature. You can initiate a new attestation document when the current attestation document is in one of the following statuses: Pending Org Signature, Accepted and Signed, or Rejected. After you initiate a new attestation, you will have to add an attestor again. Until the attestor is assigned, the attestation document status will be Draft.

    In Perform Attestation, click Send Attestation Link to Attestor via email. Two email messages with a link and an access code that allow the attestor to access and sign/decline the attestation document will be sent out.

    Note The attestation document is considered signed once the attestor has signed the document using the latest link generated by the CAQH Endpoint Directory system and is stored/tracked in a PDF format in the CAQH Endpoint Directory.

    • Draft: an attestor is yet to be assigned to the order form.
    • Pending Org Signature: the attestor has been assigned to the attestation document, but the attestor has not yet signed the attestation document.
    • Accepted and Signed: the attestor has accepted and signed the attestation document.
    • Rejected: the attestor has rejected the attestation document indicating the reason of rejection.

The organization profile in the CAQH Endpoint Directory passes through the following stages:

  1. The organization profile is created and assigned the status In Progress.
  2. After your organization profile is complete (the information is added to all the mandatory fields), you can send it for review to validate the identity of the organization. To do this, click Submit for Review and enter a description for the submission if required. The organization profile is assigned the status Pending Approval. You are not able to edit your organization profile in this status.
  3. When the organization profile is or is not successfully validated and approved by CAQH/Edifecs, the organization profile is assigned the status Approved or Rejected. If the organization profile is rejected, edit the organization profile based on the comments received in the rejection message. And if the organization profile is approved, but you need to edit a certain section of the organization profile, you should submit the updated organization profile for a review and approval once again after you have edited the organization profile. In this case, the organization profile status changes to In Progress, and after you resubmit the organization profile for a review, it is assigned the status Pending Approval.
  4. After the organization profile is approved, it gets automatically published to the Directory and becomes available for the community. Once your organization profile is published to the Directory, the profile is assigned the status Published. You still retain the ability to edit or update the profile (to do this, click Update Profile). After you edit your organization profile, the organization profile is assigned the status In Progress and must be resubmitted to CAQH/Edifecs for review and approval. Once published, the organization remains available to the community even with such status, as well as already published applications and endpoints remain as they are in the Directory even if the status of the organization profile has changed from Published.

    After your organization profile has been published, all the information on your organization is displayed on the tabs: Overview, Order Form, Attestation.

Note You cannot publish your applications and/or endpoints if the organization profile is in one of the following statuses: In Progress, Pending Approval, Accepted, or Rejected.

Note When your organization profile is not yet published, you do not have access to the sections: Partners and Connections and Directory. To access these sections, publish your organization profile first.

Discovered Organizations

The CAQH Endpoint Directory administrators can also create a discovered organization and enter information on its organization profile. In this case there's no need to submit the profile for a review.

Note If you cancel your subscription for Validated organizations, a CAQH administrator will remove your organization with all the information and child entities (applications, endpoints) from the CAQH Endpoint Directory.