Clear answers to common questions about therapy credentialing, contracting, and CredNgo software.
Credentialing is the process of verifying a provider’s qualifications—licenses, education,
training, background, and professional history—so they can participate in insurance networks
and bill payers.
Most insurance approvals take 90–120 days, depending on the payer and the completeness of
your documentation. Some Medicaid programs are faster, while commercial plans may take
longer.
Common requirements include:
We provide a complete checklist during onboarding.
Yes. We support solo providers, small groups, and multi-provider agencies. Our system is built to
handle large-volume credentialing efficiently.
If you bill under your individual name only, you need NPI Type 1.
If you bill as a business or group practice, you also need NPI Type 2.
We assist with both.
CAQH is a central database used by most insurance companies to verify provider information.
It must be:
∙Accurate
∙Updated regularly
∙Re-attested every 90 days
We manage CAQH setup, maintenance, and attestation for you.
Yes. We work with:
Coverage varies by state, but we support all major networks.
Yes—our Re-Credentialing & Maintenance service includes:
Enrollment is the process of applying to join an insurance network after your credentials are
verified. Both steps are required to bill payers.
Yes. Our team handles contract negotiation, rate review, and payer communication to help you secure better reimbursement when possible.
Not all. Medicaid and Medicare typically follow standard fee schedules. Commercial payers—like Aetna, UHC, and BCBS—often allow negotiations, especially for specialized services or growing practices.
Most payers require re-credentialing every 2–3 years. Missing this deadline can lead to termination from their network.
Not always. Some payers notify providers, others don’t. That’s why our maintenance service includes automated tracking and reminders.
An SCA is a temporary authorization that allows patients to receive care from an out-of-network provider at in-network rates.
Some approvals take a few days; others take several weeks, depending on the payer and documentation provided.
Yes. If treatment continues or medical necessity persists, many payers allow extensions.
Most NPIs are issued within 1–5 business days.
Yes. We correct taxonomy codes, business addresses, legal names, and any errors that could cause delays.
Common delays include:
We help eliminate preventable delays.
We notify you once each payer confirms approval and provide next-step guidance for billing readiness.
Pricing varies depending on the type of service, number of providers, and networks required. We offer transparent, predictable pricing with no hidden fees. (You can customize pricing later.)
No. You only pay for the required services. There are no lock-in contracts unless you choose a maintenance plan.
No. They are completely separate.
CredNgo is built for businesses that manage multiple providers:
Yes. Many organizations do. They use CredNgo for internal tracking and rely on us for professional credentialing work.
Talk directly with a CredNgo credentialing specialist and get clear, practice-specific answers before you move forward.
