Frequently Asked Questions

  • Credentialing verifies that a provider meets required professional standards, such as licensure, education, and experience. It ensures compliance with payer and regulatory requirements before participating in insurance networks.

  • Timelines vary by payer:

    • Cigna and Optum typically take 2-3 months

    • Aetna around 3-5 months

    • Humana 5–6 months

    • Blue Cross Blue Shield plans vary by state

    (Accurate as of January 2026)

  • Yes. Most insurance panels use the Council for Affordable Quality Healthcare (CAQH) database. Providers should create or maintain an updated CAQH profile with all relevant documentation and attestations.

    • CAQH profile

    • Tax ID

    • NPI 2 if you are an LLC, PLLC, SCorp, etc, even if single member

    • Professional Liability Insurance

    • An address and phone number

  • NPI 1 is known as an "individual" NPI - it is specific to the provider and tied to their social security number.  NPI 2 is known as Organizational NPI it is for contracting purposes, and specific to a business of any kind that utilizes a Tax ID.

  • Essentially, to WHOM does the contract belong? Top the business or to the provider?

    GROUP CONTRACT: The contract belongs to the business and is NOT portable- meaning if a provider with the group leaves the group, they do not take their In Network status with them. They have to start the contracting process from the beginning. All providers under the contract still have to be credentialed. Cigna & Optum do not offer group contracts until a practice has 4-6 licensed providers. Aetna & BCBS plans require only 2 providers, and some plans (like Humana) will do a group contract even if there is only one provider.

    INDIVIDUAL CONTRACT: The contract belongs to the provider, but they can list the business's Tax ID and NPI for payment purposes. With Individual Contracts, if the provider leaves the business, they DO take their in network status with them, but they need to submit an "add a Tax ID" request before they can bill at their new location.

    These variations can be confusing – many people believe they must have "Group Contracts" to hire employees. But in some cases (Cigna & Optum) they are functioning as a group but with individual contracts.

  • The provider will have to be credentialed for each tax ID and location. List each practice address separately to ensure accurate representation in provider directories.

  • Each NPI–TIN–address combination should be entered separately on rosters or applications.

  • Registered interns do not get credentialed, meaning they are not placed on a roster, and no applications are submitted on their behalf.


    They may provide services under the supervision of a licensed clinician who bills under their own NPI. This is called Supervisory Billing and is only allowed by a few plans.


    The RIs can see the clients, under the supervision of the licensed and enrolled providers. The RI sees the clients but the claims go out under the NPI and name of their supervisor, as if the supervisor did the work. Some plans require specific  modifiers to indicate supervisory billing.


    Aside from billing, there are additional requirements for proper supervisory billing: the supervisor must do the intake or do a brief before the TP is written. TP is not valid until a supervisor signs it. There must be supervision logs in place and supervisors must staff cases.

  • Most insurance payers recredential every 2–3 years to maintain compliance. Providers must maintain their various portals (CAQH, Availity, Provider Express, etc) at least quarterly to remain in compliance at all times.

  • If a panel is closed for your specialty or region, you may need to wait for an opening or consider alternative plans or networks.

  • We have a page for that! Medicare can be confusing, so it gets a special page for FAQs.

    Medicare FAQs

  • We would love to help!

    For support or to ask further questions you can: