Complete the online application request form or call one of the following numbers to request an application:
You will receive your provider agreement. Please review and sign your agreement upon receipt.
As a practitioner you must complete the credentialing process before you can participate in an Aetna network and provide care to Aetna members. This process evaluates your qualifications to practice in your elected field.
We collect and verify a practitioner's professional qualifications, such as:
Aetna participates in the Council for Affordable Quality Healthcare and accepts the CAQH application for our credentialing process. The CAQH application is a universal provider data source. The objective is to make the credentialing process more efficient for you by offering a single point of contact and eliminating the extensive paperwork during this process. CAQH is compliant with all state-required credentialing applications. When completing your application, please designate Aetna as authorized to access this information. Once completed, we can obtain your information and initiate our credentialing process.
We use the CAQH Universal Provider Data Source for our credentialing needs for all provider types. You only submit one application to one source. You update it on a quarterly basis to meet the needs of all of the health plans and hospitals participating in the CAQH effort. This saves you time and effort.
If you are registered with CAQH, you will only need to fill out the application request form online.We will retrieve your information from the Universal Provider Data Source. Please remember to provide us with authorization to obtain your credentialing information from CAQH when you fill out the application.
If you HAVE NOT previously completed an application in the CAQH Universal Provider DataSource:
Want to learn more about the CAQH Universal Credentialing Data Source? Visit the CAQH website.
Once we receive your completed application, your information will be evaluated according to our business requirements. Your credentials will be validated through the primary source. You will be notified via fax once the credentialing process is complete.
The Aetna credentialing department will notify a provider's office if erroneous information is discovered during the verification process from any primary source. It is the responsibility of the provider to work directly with the reporting entity(ies) to correct the erroneous information.
Aetna has a credentialing customer service department that is happy to assist you if you have any questions regarding your credentialing or re-credentialing process. You can contact Credentialing Customer Service:
For Medical Professionals: 1-800-353-1232
For Behavioral Health Professionals: 1-800-999-5698