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Joining the provider network FAQs
Learn about joining the Aetna® network, the credentialing process and other help topics for providers.
How to join the network
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To join our network, the first step is to fill out our application.
Are you a hospital, facility or ancillary provider?
Join the Aetna network: Facility request
Are you an individual physician/provider or physician/provider group?
To get started, choose an application type:
Based on state law, we review each request to join the network with our current network to serve our members in a specific geographic area.
Credentialing
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Credentialing is done before a health care professional joins the Aetna network. It’s a separate process from network contracting.
Credentialing involves collecting and verifying information about a provider's professional qualifications. This includes, but isn’t limited to:
- Relevant training
- Licenses
- Certification and/or registration to practice in a health care field
- Academic background
We also review whether each provider meets certain criteria for professional competence and conduct.
Learn about our credentialing policies (PDF)
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Our Credentialing Verification Organization (CVO) meets the National Committee for Quality Assurance (NCQA) standards for health plans.
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Our Credentialing Verification Organization (CVO) has earned CVO accreditation from URAC.
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Aetna uses CAQH ProView for credentialing and recredentialing. You can find help to fill out the CAHA ProView application and learn what materials you’ll need to complete your application.
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CAQH ProView is an online data source that we use to credential all health care professionals. Health plans and hospitals get application information from this database. Multiple organizations don’t need to contact the provider for the same information.
If you haven’t registered with CAQH, here are the next steps:
- Look out for your registration kit. It comes within 10 business days after you’ve sent your Aetna application request form.
- Register for CAQH and authorize Aetna to review your information. This lets us receive your data electronically and start the credentialing process.
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If you’re already registered with CAQH and received registration info, you’re almost there. You won’t get any other correspondence. Just be sure you’ve authorized Aetna to review your information.
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We’ll let you know about any information errors. Be sure to work with the reporting entity to correct the information.
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If you already applied to join the Aetna network, here’s how to request an update on your credentialing status.
For providers based in Missouri:
Fill out our form to request an update.
Missouri providers: Check credentialing status
For providers based in all other states:
Call our customer service team for updates.
- Medical and behavioral health: Call 1-800-353-1232 ${tty}.
- Dental: 1-800-451-7715 ${tty}.
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Credentialing is different from contracting. Both processes need to be complete to become an Aetna network provider. Once credentialing is complete, you’ll get a written notice. Then, your network management contact will help you complete the contracting process.
Contracting
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Our standard contract generally includes Aetna plans. If you have questions about which plans you accept, contact your network rep. Or call us at one of these numbers:
- Medical and behavioral health: 1-888-632-3862 ${tty}
- Medicare Advantage: 1-800-624-0756 ${tty}
- Dental: 1-800-451-7715 ${tty}
- Pharmacy: 1-800-238-6279 ${tty}
- All other questions: 1-888-632-3862 ${tty}
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In general, contracts automatically renew, and you don’t need to take action. If you have changes to your contract, contact your network rep. Or call us at one of these numbers:
- Medical and behavioral health: 1-888-632-3862 ${tty}
- Medicare Advantage: 1-800-624-0756 ${tty}
- Dental: 1-800-451-7715 ${tty}
- Pharmacy: 1-800-238-6279 ${tty}
- All other questions: 1-888-632-3862 ${tty}
Contacting us
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If you need more information about joining our network, we’re here to help. Here’s how to reach us:
- Medical and behavioral health: 1-888-632-3862 ${tty}
- Medicare Advantage: 1-800-624-0756 ${tty}
- Dental: 1-800-451-7715 ${tty}
- Pharmacy: 1-800-238-6279 ${tty}
- All other questions: 1-888-632-3862 ${tty}
Already an Aetna network provider? Work with us on Availity®.
Availity is your one-stop site to work with us. Confirm benefits, file claims, request prior authorization, check payments — and more.
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Health benefits and health insurance plans contain exclusions and limitations.