How to apply

Complete the online application request form or call
one of the following numbers to request an application:

• Individual Medical Professionals: 1-800-353-1232
• Dental Providers (excluding oral/maxillofacial surgeons): 1-800-451-7715
• Behavioral Health Professionals: 1-800-999-5698

Practitioners must complete the credentialing process before they can participate in an Aetna network and provide care to Aetna members. This process evaluates their qualifications.

We collect and verify a practitioner's professional qualifications, such as:

• Relevant training
• Licensure
• Certification
• Registration to practice in a health care field
• Academic background
• An assessment of whether the practitioner meets certain criteria relating to professional competence and conduct

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 have registered with CAQH, we will accept this information in place of the application. Just 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.
• Once you complete the CAQH application, we obtain your application data electronically and begin the credentialing process.
• If you are not registered with CAQH, call for a registration kit within. You will receive it in 7 to 10 business days. Complete the CAQH application and be sure to grant "Aetna" authorization to review your information.

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 as described in step 2 above. Once this process is complete, you will receive written notification as to your participation status with Aetna.

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