CAQH work history mistakes stall more credentialing files than any other section of the profile, and nearly all of them trace back to a gap nobody explained. A plan reviewer sees March at one job and May at the next, has no idea what happened in April, and sends a request for clarification. The file sits in pending status until someone answers it. CAQH rebranded as DataSpring in 2026, but the provider profile and its work history rules work the same way they always have.
Key Takeaways
- Health plans accredited by NCQA review at least the most recent five years of work history, with the month and year for every position.
- Gaps longer than six months must be explained, and gaps longer than a year need a written explanation.
- Many plans and hospitals ask for more than the minimum, so explaining every break up front avoids follow-up requests.
- Each locum assignment and each overlapping per diem job gets its own entry, with hours that show which job was primary.
- Any change to work history means reattesting the profile, which CAQH already requires every 120 days.
What Payers Check in Work History
The CAQH ProView form asks for each position’s employer, address, role, start and end dates, and whether the job was full-time or part-time. Plans pull that section into their own review, and most of them follow the NCQA credentialing standards. Those standards require at least five years of work history with month and year dates, an explanation for any gap longer than six months, and a written explanation for any gap longer than a year.
That’s the floor, not the ceiling. Hospital medical staff offices often want a complete history back to training, and some plans flag gaps of three months or less under their own policies. Our post on NCQA standards covers the rest of what accredited plans verify.
Which Breaks Count as Gaps
A gap is any stretch inside the review period that isn’t covered by a listed position or an explanation. The most common one sits between residency and the first attending job. A physician who finished training in June and started work in September has three months to account for, even if those months went to boards, a move, and onboarding paperwork.
Transitions between jobs create the next largest group. Leaving a practice in December and starting at a hospital in February leaves January open. A few days between a Friday end date and a Monday start date isn’t a real gap, since plans compare months, but anything that spans a full month should be covered.
Part-time work causes a quieter version of the same problem. A provider who lists only the specific weeks they worked at a clinic, instead of the full span of the job, creates a string of small gaps that weren’t really there. The credentialing committee reviewing the file can’t tell the difference unless the entry does.
How to Explain a Gap
The fix is a separate entry that covers the gap dates and says briefly what the provider was doing. Credentialing committees don’t need personal details. They need to see that the time was accounted for and that it didn’t involve discipline or a lost license.
Training and board preparation
Fellowships, additional certifications, and post-residency board study all belong in work history. A fellowship gets its own entry with the program name, dates, and a program director contact. A study period gets a gap entry such as “Post-residency board preparation and relocation.”
Parental, medical, and family leave
A short note like “Parental leave” or “Medical leave, returned to full practice” is enough. Providers don’t have to name a diagnosis, and a leave taken while still employed can be noted on that employer’s entry instead of a separate one.
Job search and relocation
“Relocated from Ohio to Pennsylvania, seeking local position” covers most transition gaps. For a gap longer than six months, a sentence on why it ran long helps the committee close the question without a follow-up.
Military service
Active duty is listed like any other position, with branch, rank, dates, and the clinical role. Reserve or Guard duty performed alongside civilian work doesn’t create a gap, but it’s worth listing if it took significant time.
Entry Errors That Stall Verification
Plans and hospitals verify work history by contacting employers, so the entry has to lead somewhere. The legal name of the employer matters, since “City Hospital” may be “Metropolitan Health System d/b/a City Hospital” in the verifier’s records. A main switchboard number rarely reaches anyone who can confirm dates, so the medical staff office or HR number works better.
Supervisor contacts go stale fast. A department head who left five years ago can’t confirm anything, and a department contact usually lasts longer than a named person. Dates need at least a month and year, and a vague role like “Physician” invites questions that “Emergency physician, Level II trauma center, full-time” doesn’t.
Overlapping and Part-Time Positions
Many providers hold more than one job at a time, such as a full-time hospital position plus per diem shifts at an urgent care. Each job gets its own entry, and the full-time or part-time field, along with approximate hours, shows which one was primary. Without that, two overlapping jobs both marked full-time look like an error.
- Hospital A, emergency medicine, full-time (40 hours a week), January 2020 to present
- Urgent Care B, physician, per diem (8 to 16 hours a week), March 2021 to present
A part-time job should be listed for its full span, from the first shift to the last, with the part-time status noted. Listing only the weeks worked creates gaps that didn’t exist.
Locum Tenens Assignments
Locum work is the hardest history to document, because one year can include four or five facilities. Each assignment needs its own entry with the facility name, location, dates, and a contact. When an agency was the employer, list the agency and name the facility in the description, so the verifier knows where the work happened.
The time between assignments counts too. A month off between two locum jobs needs a gap entry such as “Between locum assignments.” Providers who work locums regularly should log each assignment as it ends, since rebuilding three years of short placements from memory rarely works. The billing side of locum coverage has its own rules, covered in our post on locum tenens billing.
Rebuilding Dates You Don’t Remember
W-2s show which employers paid the provider each year, which narrows the timeline. Former employers’ HR departments can usually confirm exact dates, sometimes for a small fee. Old CVs, privileging applications, and onboarding emails often hold dates that have since been forgotten.
When an exact date can’t be found, the entry should use the best available month and note that verification has been requested. An estimate that’s labeled as one causes fewer problems than a guess presented as fact.
What Happens When a Gap Goes Unexplained
The plan sends a request for clarification, and the application moves to pending until someone answers it. The provider then has to update the profile, reattest, and tell the plan the profile has changed. That cycle commonly adds four to eight weeks, on top of the normal credentialing timeline, and a plan that doesn’t hear back may close the file entirely.
A stale profile causes a related problem after approval. If the provider misses a reattestation, plans can stop paying claims even though the provider is still in network, which our post on ghost providers covers in detail. Keeping work history current is part of keeping the whole profile current.
Four Work History Fixes from Real Files
Residency to first job
A family physician finished residency on June 30 and started her first position on September 1, with nothing listed in between. Adding an entry for July 1 to August 31, labeled “Post-residency board preparation and relocation,” closed the question.
Parental leave after leaving a job
A physician stopped working in March and returned in January, without listing the months between. An entry for April through December labeled “Parental leave” was all the plan needed.
One month between jobs
A hospitalist’s history ended at one hospital in December and started at a clinic in February. A one-month entry labeled “Career transition, interviewing for new position” resolved it.
Two full-time jobs at once
A surgeon listed full-time work at a practice and full-time work at a hospital over the same years. Changing the hospital entry to “Per diem, about two shifts a month” made the overlap make sense.
CAQH Work History FAQ
How many years of work history does CAQH need?
Plans that follow NCQA standards review at least the most recent five years, with the month and year for each position. Some plans and hospitals ask for more, so many credentialing teams document the full history back to training.
How long does a gap have to be before it needs an explanation?
Under NCQA standards, gaps longer than six months must be explained, and gaps longer than a year need a written explanation. Some plans flag shorter gaps, so explaining any break of a month or more is the safer approach.
Do a few days between jobs count as a gap?
No. Plans compare months, so a weekend or a week between two positions isn’t treated as a gap. A full month or more without a listed position is.
How should locum tenens work be listed?
Each assignment gets its own entry with the facility, dates, and a contact. If an agency was the employer, list the agency and name the facility in the description, and add gap entries for any time between assignments.
Do I have to reattest after updating work history?
Yes. Any change to the profile requires reattestation, and CAQH requires reattestation every 120 days even without changes. Plans see the update only after the profile is reattested.
Is CAQH ProView still used now that CAQH is DataSpring?
Yes. CAQH rebranded as DataSpring in 2026, but providers still sign in to the same profile, and plans still pull work history from it the same way.
How Medwave Cleans Up Work History Before Payers See It
Most of the work history problems we fix never needed to happen. Medwave builds each provider’s timeline before anything goes into the profile, closes every gap with an entry a committee will accept, and confirms that each employer contact can verify the dates. Our credentialing specialists also track reattestation dates, so a profile that was right at approval stays right.
Our medical credentialing team averages 85 days from application to approval across payers, and clean work history is a big part of why.
If a plan has already sent you a gap request, the form below is the fastest way to get it answered.
Co-Founder and COO of Medwave, bringing more than 25 years of hands-on experience in healthcare revenue cycle management, payer contracting, and medical credentialing.