ABA Credentialing Made Simple: A Guide for Starting an ABA Practice

Starting an ABA practice requires more than just clinical expertise—it demands a rock-solid foundation built on proper credentialing. In today's insurance-driven healthcare landscape, effective ABA insurance credentialing opens doors to more clients, smoother reimbursements, and sustainable growth for your practice.

I've spent years helping ABA practitioners navigate these murky waters, and this guide shares the hard-won insights that have saved our clients countless headaches and thousands of dollars in lost revenue.

What is ABA Credentialing and Why Is It So Important?

ABA credentialing services encompass the processes insurance companies use to verify that you meet their requirements to deliver applied behavior analysis therapy. This verification includes checking your education, certifications, licenses, and professional experience.

Without proper ABA credentialing in place, you simply cannot bill insurance companies, creating a massive barrier between you and clients who rely on their insurance coverage.

Being properly credentialed for ABA therapy doesn't just give you a professional stamp of approval, it also:

• Expands your client base: Once your BCBA credentialing is complete, you're added to insurance networks, dramatically increasing your visibility to potential clients.

• Streamlines your payments: Insurance companies process claims much more efficiently for properly credentialed providers, improving your cash flow.

• Boosts your credibility: I've watched practices that implement thorough ABA insurance credentialing experience up to 30% increases in client referrals. The trust this builds with clients and referral partners is invaluable.

  
  

"Credentialing isn't just paperwork—it's the foundation that allows your clinical expertise to reach the families who need it most." Read More About the Credentialing Process

ABA Credentialing vs. Contracting: Understanding the Crucial Difference

Many practitioners use these terms interchangeably, but they represent two distinct steps in working with insurance companies:

Credentialing

This first step verifies your professional qualifications. Insurance companies review your education, work history, certifications, and licenses to ensure you meet their standards for providing ABA therapy. This verification is essential for BCBA credentialing compliance and for eventually setting up your ABA therapy billing systems.

Contracting

Once credentialed, you'll move to contracting—signing a formal agreement with the insurance company that outlines payment rates and relationship terms.

Important note: Being credentialed and contracted doesn't automatically mean you're cleared to see clients. You'll still need to go through each payor's process to get client-specific authorizations. I've seen many practices make this costly assumption! Read More about being credentialed and contracted by

Credentialing Know-How from Real ABA Billing Veterans

"Proper credentialing isn't just paperwork—it's the backbone of getting paid in this field."

What We've Learned About ABA Insurance Credentialing

Look, after handling credentialing for hundreds of ABA practices since 2013, we've pretty much seen everything at Cube Therapy Billing. The stuff that gives most practice owners migraines for months? We've turned it into something manageable.

Things we do differently around here:

• We get applications processed way faster than most in-house staff can

• We catch those weird rejection triggers that trip up almost half of first-timers

• We stay on top of renewals before they become problems

  
  

Individual vs. Group Contracts: A Critical Choice

I remember this psychologist who came to us back in 2018. She'd set up an individual contract, thinking it would be simpler. Then she hired two BCBAs that summer, and bang—total nightmare trying to get everyone covered.

For solo practitioners: Individual contracts can work fine if you're truly staying solo. You'll deal directly with each insurer, and the process is straightforward enough. The trouble comes when you grow, and most practices do.

For practices with growth plans: Group contracts make so much more sense, even for small operations. One of our clients started with just herself and one other therapist. Three years later, they had 12 providers—and because we'd set them up with group contracts from day one, adding people was relatively painless.

True story: A client in Texas forgot to remove a part-time person who'd moved to Oregon from their contract. Three months of rejected claims later, they were still untangling the mess. Always, always remove departed providers from your contracts immediately!

The Paperwork Avalanche: Building Your Credentialing Arsenal

Jen, our operations director, has this saying about credentialing documents: "It's not a pile, it's a mountain." Getting your ducks in a row early saves massive headaches down the road.

You'll need to gather:

For each provider:

• Education transcripts and diplomas (we've had clients whose applications stalled for weeks over missing transcripts)

• Every place they've worked for the past 5-10 years, with contact info

• All licenses, certifications, with issue/expiration dates

• We keep secure digital copies of everything because insurers love to "lose" documents

  
  

Don't forget the basics:

• Liability and malpractice insurance docs (check them yearly!)

• Your tax ID and all NPIs

• Physical location information, right down to suite numbers

• CAQH logins and profile info

• Details about what services you actually provide

  
  

Last December, we took over for a practice that had been trying to get credentialed with Blue Cross for four months. Turned out they were missing a single liability form that their previous biller had overlooked. We had them approved three weeks later.

Each Payor Has Its Own Bizarre Process

This is probably the most frustrating part for practices that try to handle this themselves. There's absolutely zero standardization between insurance companies when it comes to ABA billing services.

Before we even start an application, we ask:

• Will this company's rates actually work for your business model?

• How quickly do they typically pay claims?

• Are their authorization processes reasonable or nightmarish?

  
  

Here's something bizarre we discovered: Cigna requires photos of physical office locations in the Southeast region, but not in the Midwest. It's not written anywhere, obviously—we only learned after seeing several applications rejected. These are the kinds of quirks you discover after processing thousands of applications.

The Follow-Up Game Changes Everything

Here's the single biggest difference between successful credentialing and stalled applications: aggressive, persistent follow-up. Insurance companies simply don't move applications forward on their own.

Our approach:

• We track every single application with detailed notes

• Someone from our team calls every 10-14 days on standard applications

• Complex cases get weekly calls

• We write down exactly who said what, with employee IDs when possible

• We're politely relentless

  
  

I'm convinced that without our follow-up system, about a third of all applications would just sit there collecting digital dust forever. The squeaky wheel absolutely gets the grease here.

Better Technology Makes a Real Difference

After watching too many practices struggle with Excel spreadsheets and sticky notes to track their credentialing, we invested in specialized software. The difference has been night and day:

Our clients see:

• Drastically fewer errors in submissions

• Much less time spent chasing paperwork

• Faster processing times overall

• No more sudden surprises about expired credentials

  
  

A practice in California saved nearly $12,000 last fall when our system caught a potential billing issue before it became a disaster. This technology isn't cheap, but it pays for itself quickly.

After You're Credentialed: The Real Work Begins

This is where many billing companies drop the ball—they help you get credentialed, then pretty much disappear. Our approach is completely different:

We handle:

• Setting up advance warnings at 90, 60, and 30 days before anything expires

• Tracking the different CEU requirements for each payer

• Notifying every single insurance company whenever your information changes

• Making sure each client has proper authorizations in place

  
  

A perfect example: One of our client practices moved to a larger office last spring. We notified every insurer immediately, with all the required documentation. Their former biller had missed this step during a previous move, which had resulted in nearly $30,000 in delayed payments.

Why Specialists Make Sense for ABA Credentialing

When practices finally get their credentialing and billing processes working smoothly, everything changes:

• You can actually forecast your monthly income

• Cash flow evens out

• Your clinical people can focus on what they do best

• The constant paperwork anxiety disappears

  
  

"Getting professional help with our ABA insurance credentialing was the best business decision we ever made," one of our long-term clients told me recently. "I just wish we'd done it three years earlier." Read More about Starting Your Own ABA Clinic

Want to get your credentialing sorted out once and for all?

We've put together a free credentialing checklist based on our work with hundreds of ABA practices.

Drop us a line: info@cubetherapybilling.com

Frequently Asked Questions About ABA Credentialing

How long does the ABA credentialing process typically take?

The ABA credentialing process usually takes between 60-120 days, depending on the insurance company and the completeness of your application. Some payors like Medicaid can take even longer—up to 6 months in certain states. Start early and follow up regularly!

Can I see clients while waiting for my ABA insurance credentialing to be approved?

You can see clients while waiting for credentialing approval, but you typically cannot bill the insurance company until the process is complete. Some practices choose to see clients and hold claims until credentialing is finalized, while others have retrospective billing arrangements with certain insurers. Always check the specific policies of each payor.

What's the difference between being in-network and out-of-network for ABA therapy billing?

In-network providers have completed the credentialing process and signed contracts with specific insurance companies, agreeing to accept their negotiated rates. Out-of-network providers haven't established these formal relationships and typically face higher patient responsibility portions and more complicated reimbursement processes.

How often do I need to renew my ABA credentialing?

Most insurance companies require re-credentialing every 2-3 years, though some may require it annually. Each payor has different timelines, so maintaining a credentialing calendar is essential for your ABA billing services to run smoothly.

What are common reasons ABA credentialing applications get rejected?

The most common reasons for rejection include incomplete information, missing supporting documentation, lapses in malpractice insurance, failure to disclose professional history issues, and errors in NPI or tax identification numbers. Over 40% of initial applications have some form of error that causes delays!

Can I use a third-party service for my ABA insurance credentialing?

Absolutely! Many ABA practices outsource their credentialing to specialized services. While this involves an additional cost, these experts often speed up the process and reduce errors significantly. For growing practices, the time savings and increased approval rates typically justify the investment.

What documentation do I need for ABA therapy billing after credentialing?

After completing credentialing, you'll need comprehensive session notes, current treatment plans, authorized supervision documentation, progress reports, and proper diagnostic codes for effective ABA therapy billing. Insurance companies are increasingly scrutinizing documentation quality during audits.