How to Avoid Common Pitfalls in CAQH and PECOS Setup

Jovin Richard
Jun 16
2 min read

At ACCORDPRO, we’ve helped hundreds of providers navigate the complexities of credentialing, including CAQH and PECOS enrollment. Here’s how to avoid the most common mistakes and keep your practice moving forward.

Simplify Provider Enrollment and Speed Up Reimbursement

Setting up CAQH and PECOS profiles correctly is critical for any healthcare provider entering insurance networks or enrolling in Medicare. Yet, many practices lose weeks—or even months—of revenue due to incomplete applications, missing documentation, or technical errors.

1. Using Incomplete or Inconsistent Information

Even minor mismatches between documents (like NPI registration, practice address, or license info) can cause application delays or rejections.

What to Do: Ensure consistency across CAQH, PECOS, NPPES, and IRS records. Use a centralized credentialing data sheet to standardize information for all submissions.

2. Skipping Document Uploads in CAQH

Many providers forget to upload required documents such as malpractice insurance, state licenses, or DEA certificates—which stalls payer credentialing.

What to Do: Maintain a current digital folder with all key documents. Check CAQH’s document checklist regularly and set calendar reminders to update expiring files.

3. Failing to Attest CAQH Profile Every 120 Days

A complete CAQH profile won’t be visible to payers unless it’s attested. Failure to attest results in enrollment rejections or long processing delays.

What to Do: Set quarterly calendar reminders for attestation. ACCORDPRO clients benefit from automated reminders and profile monitoring as part of our credentialing service.

4. Incorrect Group or Reassignment Details in PECOS

Adding the wrong practice location, TIN, or failing to link the provider’s NPI to the group correctly in PECOS leads to claim denials.

What to Do: Double-check that all group affiliations and reassignment sections are completed. Ensure the provider's NPPES and PECOS data align exactly with the group enrollment.

5. Submitting Before Profile Completion

Many providers submit applications to payers or Medicare before their CAQH or PECOS profiles are properly completed or validated.

What to Do: Only submit applications once all fields are fully updated and verified. Have a credentialing expert review the setup to catch errors before they reach the payer.

6. Not Monitoring Application Status

Even correctly submitted profiles can stall without timely follow-up. Many payers and MACs require direct contact to process files.

What to Do: Track application status weekly. ACCORDPRO follows up with payers and Medicare administrators on your behalf, ensuring applications don’t sit idle.

Final Thoughts

Whether you’re onboarding a new provider or switching groups, a smooth CAQH and PECOS setup is essential to avoid payment delays and compliance headaches.

ACCORDPRO streamlines the process with expert credentialing support, ensuring your applications are accurate, complete, and on track from day one.

Need help with CAQH or PECOS setup?