Credentialing FAQs

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I already submitted a CAQH application, do I need to complete a Maryland Uniform Credentialing Form or District of Columbia Uniform Credentialing Form also?

Answer: No, once you've submitted your information through CAQH ProView® and completed the CareFirst CAQH Questionnaire, you have satisfied the credentialing requirements for both the Maryland and District of Columbia Uniform Credentialing forms.

Who do I notify if I move my practice or make any change to my office contact information, such as telephone or fax number?

Answer: Please log into CAQH ProView® as soon as possible to make any changes. This information will then be shared with CareFirst.

How often do I need to update my information?

Answer: After providers complete their CAQH ProView application, CAQH will notify them every four months or 120 days to re-attest that all information is still correct and complete. If during that four-month period any practice information changes, you should update your information directly with CAQH.

Who do I call if I have additional questions regarding credentialing and participation?

Answer: Call CareFirst Provider Information and Credentialing at 410-872-3500 or 877-269-9593.

When can health care providers who offer lactation consultation services start the credentialing process?

Answer: On May 9, 2019 lactation consultant providers will be able to begin the credentialing process using CAQH ProView®.

If you are not yet registered for CAQH ProView, learn more and register at http://proview.caqh.org/, or learn more from their Directory Reference Guide or Frequently Asked Questions.

Who may provide lactation consultations?

Answer: Lactaion Consultantions may be provided by certain licensed medical professionals who possesses specific training in Lactation Consultation. Other medical professionals may provide Lactation Consultations if they have one of the following certifications:

  • CLC - Certified lactation counselors (CLC) are professional breastfeeding specialists trained and certified to counsel mothers about breastfeeding and to help with a variety of breastfeeding issues.
  • IBCLC - An International Board Certified Lactation Consultant (IBCLC) specializes in comprehensive breastfeeding support and counseling, and the clinical management of breastfeeding. An IBCLC has completed extensive formal lactation education, clinical training, has passed an international certification exam, and has continuing education requirements in lactation. They may also be called a Registered Lactation Consultant.

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