CAQH Practice-Location Review: What the 90-Day Response Window Means
CAQH can present health-plan-submitted locations for provider review; unresolved requests can be reported as No Response after 90 days. This is not a universal 90-day location attestation cycle.
The phrase “CAQH location confirmation every 90 days” is easy to repeat and easy to overstate. Current CAQH user guidance describes health-plan-submitted practice locations that a provider may be asked to review. When such a proposed location is not accepted or rejected within 90 days, CAQH can communicate a No Response outcome to the health plan. That is a response window for a location-review request; it should not be turned into a blanket rule that every provider must perform a universal practice-location attestation every 90 days. Practices should still review locations routinely because directory accuracy matters, but the maintenance calendar needs to distinguish CAQH profile re-attestation from specific location requests and from payer directory-validation obligations.
Separate the 90-day location-request window from routine CAQH re-attestation
CAQH materials distinguish credentialing attestation from directory location confirmation.
CAQH describes location confirmation on a 90-day cadence and credentialing attestation on a 120-day cadence.
Location accuracy affects payer directories and patient-facing information, not just credentialing files.
CAQH profile re-attestation and location review are different functions. Re-attestation generally follows the 120-day cadence for most providers and 180 days for Illinois providers. Separately, CAQH guidance for its location-review feature explains that participating health plans may submit locations they have on file and that unresolved location requests can be communicated as No Response after 90 days. Put those items in different calendar categories. If the office creates a recurring “confirm all locations every 90 days” task, it may be doing useful internal hygiene, but it should not present that local policy as the CAQH rule.
Review proposed locations against where the provider actually practices
A practice with multiple sites should maintain an authoritative location inventory.
Closing, moving, or adding sites may also trigger Medicare and payer enrollment changes.
Two recurring clocks are easier to manage when one location inventory feeds both. Do not maintain a separate “CAQH address list” from the practice’s real operating record.
When a proposed location appears, compare it with scheduling, lease/office records, employment information, and the clinician’s actual service pattern. Similar street addresses can hide a different suite, TIN, group, or historical office. Ask whether the provider currently furnishes services there and whether the location belongs to the organization shown. If the payer’s proposed location is recognizable but stale, do not accept it merely to make the alert disappear. A wrong acceptance can reinforce bad directory data instead of correcting it.
Accept a location only after verifying entity, TIN, address, and service facts
Before accepting a location, verify practice name, TIN relationship, full address, suite, phone, service availability, and other details the CAQH record requests. Confirm the provider’s license and payer enrollment support practicing there where applicable. If the location is new, identify its operational start date. Save a note or source evidence for the review because another payer may later ask why the location was added. The correct location record should describe real practice, not merely a place where the organization receives mail or a headquarters where the clinician never sees patients.
Reject or archive locations that do not represent current practice
Using the 120-day credentialing reminder as the only CAQH maintenance event. A brief second-person check before submission is usually faster than answering a development request after the fact.
Confirming a location that is technically open but no longer accepts the relevant patients. When this happens, correct the source record first and then update the downstream copies that are actually affected.
Failing to distinguish service, mailing, billing, and telehealth addresses. Do not bury this under a generic “pending” label. Name the blocker, the owner, and the next action.
Updating CAQH while leaving Medicare or payer enrollment records stale. A copied prior application is especially risky here because an old file can be internally consistent and still be wrong for the current facts.
If the provider no longer practices at a location, use the appropriate CAQH profile/history functionality and reject a payer-proposed current location when it is not valid. Preserve historical employment or location information as required rather than deleting facts that belong in the provider chronology. If a location was never associated with the provider, document that clearly. This is particularly important after practice acquisitions, clinician departures, or suite moves, when payer databases may continue sending old addresses back into shared data workflows.
Trigger payer and directory updates when a real location change is discovered
Location inventory: Store it with the transaction rather than in a personal downloads folder or one coordinator’s inbox.
Caqh confirmation record: Tie the document to the specific field or decision it supports.
Payer directory screenshots: Record where it came from and when someone verified it.
Pecos/nppes change evidence when applicable: Preserve the prior version when an effective-date sequence could matter in a later review.
Closure/opening dates: Keep the current version and enough history to show when it changed.
A location review can reveal a broader change that CAQH alone does not finish. A new office may require NPPES updates, Medicare change reporting, commercial payer location enrollment, group roster work, malpractice confirmation, directory corrections, or local billing-system configuration. Route the discovery through change intake and open payer-specific tasks. Conversely, a closed site may need terminations across several systems. Treat CAQH as one place where location inconsistency surfaces, not as the only place the inconsistency must be fixed.
Track open location requests as tasks instead of inventing a recurring 90-day rule
Create a queue for open CAQH location requests with request date, provider, proposed location, source health plan when visible, reviewer, decision, and completion date. Escalate items before the 90-day response window expires. Separately, run an internal periodic location audit at a cadence that fits the practice’s change volume. The internal audit can be quarterly if useful, but label it as an office control. Accurate wording matters because SOPs become training material, and a made-up universal 90-day CAQH rule will be copied long after anyone remembers where it came from.
Operational checklist
- Maintain one location table with address type, phone, hours, services, and open/closed status.
- Review it before each 90-day CAQH confirmation.
- Confirm or correct the profile location data.
- Route true location changes into Medicare and payer workflows when needed.
- Audit public directory displays after the update.
- Document the confirmation date and the next review owner.
Frequently asked questions
Does CAQH require every provider to confirm all practice locations every 90 days?
Current CAQH guidance supports a narrower statement: certain health-plan-submitted location review requests can receive a No Response outcome if not acted on within 90 days. That is not the same as a universal recurring location attestation for every provider.
What should a provider do with a payer-proposed location that is no longer active?
Do not accept it merely to clear the alert. Review the facts, reject or update the location using the appropriate CAQH workflow, and trigger payer/directory corrections where the stale address also exists downstream.
Does accepting a CAQH location complete Medicare or commercial payer location enrollment?
No. A real location change can require separate NPPES, Medicare, commercial payer, directory, licensing, or billing-system work. Track those dependencies independently.
Sources reviewed
Health-plan-submitted location review requests can be reported as No Response when not accepted or rejected within 90 days.
Current CAQH profile, attestation, document, authorization, and practice-location review workflow.