.png)
Group vs. Individual Credentialing: Which is best for your ABA practices
- Vina Goodman
- 1 day ago
- 5 min read
Every ABA provider knows that insurance participation can make or break a practice’s success. That’s where ABA credentialing comes in. It ensures that ABA providers meet professional standards and are approved to deliver billable services under health plans. Credentialing verifies education, licensure, certification, and professional history, creating a trusted framework for payer relationships.
To understand how this process unfolds, see the Step-by-Step Credentialing Guide for Healthcare Providers
Understanding ABA Credentialing
The ABA credentialing process involves gathering essential documentation—licenses, liability insurance, NPI numbers, and certifications—and submitting them to insurance companies for approval. Most insurers require both initial credentialing and recredentialing (every two to three years).
An ABA credentialing services or therapist credentialing services provider often manages these steps to prevent delays and ensure compliance.
Types of Credentials in ABA Practice
Individual Provider Credentialing—Verifies the credentials of each BCBA or therapist.
Group Credentialing—Registers the organization as a single entity under one tax ID.
Facility or Multi-Specialty Credentialing—For large centers offering multiple therapy types (ABA, speech, OT, PT).
For a deeper comparison, read Group vs. Individual Credentialing: A Complete Guide for ABA Therapy Practices.
Credentialing’s Role in Insurance Reimbursement
Credentialing directly impacts reimbursement rates and payer relationships. Once approved, providers can bill insurance under their credentialed status. Errors in credentialing can cause payment holds, claim denials, and audit risks.
Why is Credentialing Necessary for ABA Practices
ABA Credentialing plays a direct and crucial role in how ABA providers get reimbursed for their services. Credentialing directly impacts reimbursement rates and payer relationships. Without proper credentialing, providers cannot bill insurance companies for ABA therapy sessions. A well-executed credentialing strategy reduces claim denials, accelerates cash flow, and reinforces compliance with payer regulations.
An Overview of Group vs. Individual Credentialing
ABA practices can pursue either group credentialing (credentialing the practice or organization as a single entity) or individual credentialing (credentialing each provider separately). Each option affects revenue, flexibility, and long-term scalability differently. The decision depends on your practice size, goals, and administrative capacity.
Group Credentialing
Group credentialing registers the ABA organization under one NPI and tax ID, letting multiple providers bill through the same system. This approach simplifies claim submissions, insurance communication, and payer coordination—helping practices run more efficiently.
Advantages of Group Credentialing
Streamlined Process: Once a group is credentialed, adding new therapists is quicker and easier. This is especially beneficial for growing ABA practices with frequent staff changes or expansion plans.
Cost-Effectiveness: Because only one application covers the group, administrative time and costs drop significantly. Insurance networks often require fewer submissions, saving both effort and money.
Enhanced Collaboration: With everyone operating under one billing framework, communication becomes smoother. Scheduling, claim management, and coordination between therapists improve, promoting teamwork and consistent workflows.
Disadvantages of Group Credentialing
Limited Individual Recognition: Therapists credentialed under a group don’t have personal visibility with insurance payers. If they move to another practice, they must complete the ABA credentialing process again to bill independently.
Potential for Group Liability: Any compliance errors, billing issues, or documentation problems can affect the entire organization. This shared responsibility makes it vital to maintain strong oversight and regular internal audits.
Individual Credentialing
Individual credentialing involves credentialing each therapist or BCBA separately. Each provider’s credentials are reviewed independently by insurance panels. This process gives the individual full recognition and control over their professional profile.
Advantages of Individual Credentialing
Personal Branding and Recognition: Individual credentialing strengthens the provider’s reputation. Therapists gain direct recognition with insurers, which can help when transitioning between practices or expanding private caseloads.
Flexibility in Practice: Credentialed individuals can operate under multiple group NPIs or as independent contractors. This flexibility benefits therapists working across multiple ABA practices or telehealth setups.
Direct Control Over Credentialing: Providers can manage their recredentialing schedules and maintain their own professional documents, ensuring accuracy and compliance.
Disadvantages of Individual Credentialing
Time-Consuming Process: Each provider must submit separate applications, which can take 60–120 days or more for approval. For large teams, this slows down onboarding and service delivery.
Higher Costs: Multiple applications mean higher administrative expenses, both in labor and fees. For small practices, this can strain budgets.
Choosing Between Group and Individual Credentialing
The choice depends on your practice model, long-term goals, and administrative bandwidth.
Example
A 20-provider ABA center expanding across states will benefit from group credentialing for operational efficiency. A solo BCBA launching a private practice should opt for individual credentialing for autonomy and control.
Leveraging Therapist Credentialing Services
Managing insurance applications and compliance can be time-consuming, which is why many practices rely on ABA credentialing services or therapy credentialing services to take care of the process. ABA credentialing specialists handle every detail—from initial paperwork to payer communication—so your team can focus on clients instead of chasing approvals.
Key Benefits
Faster Turnaround: Prevents submission delays.
Accurate Documentation: Ensures compliance with payer rules.
Full Management: Covers enrollment, recredentialing, and maintenance.
Reduced Denials: Minimizes claim rejections through accuracy.
If approvals are taking longer than expected, review How to Overcome Medicaid Credentialing Delays and Speed Up Approval for tips on streamlining the process.
Services Offered
Includes enrollment, eligibility checks, payer appeals, and ongoing updates.
Choosing the Right Partner
Avoid services with hidden fees or limited ABA experience. Opt for experts in ABA insurance credentialing or physical therapy credentialing services for reliable results.
Therapist credentialing services handle paperwork, track renewals, and follow up with insurers, ensuring faster approvals and fewer delays. By keeping credentials accurate and up-to-date, they help ABA practices stay compliant and maintain steady cash flow.
FAQ
1. What is the ABA credentialing process?
The ABA credentialing process confirms a provider’s qualifications—such as licenses, education, and certifications—to gain insurance approval. It ensures therapists meet payer requirements, making them eligible to bill confidently for ABA therapy services.
2. What are the two types of credentialing?
There are two types of credentialing: group credentialing and individual credentialing. Group credentialing registers an entire practice under one tax ID, while individual credentialing verifies each provider separately, offering more flexibility and personal recognition.
3. Is a type 1 NPI an individual or a group?
A Type 1 NPI represents an individual provider, such as a BCBA or therapist, and is used for personal billing. A Type 2 NPI is assigned to clinics or organizations that provide therapy services as a group.
Conclusion
Choosing between group and individual credentialing is an important decision that affects how your ABA practice operates and grows. Group credentialing helps larger teams work efficiently under one system, while individual credentialing gives independent providers greater flexibility and visibility.
Whichever path you choose, working with an experienced ABA credentialing specialist can make the process smoother, reduce errors, and keep your practice compliant. Most importantly, it frees you to focus on what truly matters—providing quality care to your clients.
